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Organization

SUPPORTIVE ALTERNATIVE LIVING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA H.F PETERS (EXECUTIVE DIRECTOR)
(248) 685-2639
Entity
Organization

Contact information

Practice address
425 W HURON ST, SUITE #130, MILFORD, MI 48381-2242
(248) 685-2639
(248) 685-7524
Mailing address
425 W HURON ST, SUITE #130, MILFORD, MI 48381-2242
(248) 685-2639
(248) 685-7524

Taxonomy

Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary

Other

Enumeration date
05/02/2017
Last updated
05/02/2017
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