Organization
KEVDACO HUMAN SERVICEA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN E UWAZURIKE (PRESIDENT)
(248) 569-1040
Entity
Organization
Contact information
Practice address
23999 NORTHWESTERN HWY, SUITE 200, SOUTHFIELD, MI 48075-2578
(248) 569-1040
(248) 569-1310
Mailing address
23999 NORTHWESTERN HWY, SUITE 200, SOUTHFIELD, MI 48075-2578
(248) 569-1040
(248) 569-1310
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/26/2011
Last updated
01/26/2011
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