Organization
MY HOME AWAY FROM HOME RESIDENTIAL & PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS STAR BILLY SCHUMAKE (OWNER/C.E.O)
(313) 989-7092
Entity
Organization
Contact information
Practice address
1155 W MCNICHOLS RD APT 106, HIGHLAND PARK, MI 48203-2514
(313) 989-7092
Mailing address
1155 W MCNICHOLS RD APT 106, HIGHLAND PARK, MI 48203-2514
(313) 989-7092
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
E4609Q
MI
Other
Enumeration date
06/09/2014
Last updated
06/09/2014
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