Organization
LIVELY RESIDENTIAL PARADISE
Active
Other names
Lively Facilitated Living
Organization subpart
No
Provider details
NPI number
Authorized official
SANTANNA LIVELY (OWNER)
(313) 340-2225
Entity
Organization
Contact information
Practice address
16558 MANSFIELD ST, DETROIT, MI 48235-3631
(313) 229-6215
Mailing address
25900 GREENFIELD RD STE 350, OAK PARK, MI 48237-1297
(313) 229-6215
(404) 900-3987
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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