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Organization

VITALITY ADULT FOSTER CARE HOME CO

Active
Other names
Vitality AFC Home
Organization subpart
No

Provider details

NPI number
Authorized official
BRENAE P WEAVER RN (FACILITY ADMINISTRATOR)
(248) 995-5410
Entity
Organization

Contact information

Practice address
11445 MINDEN ST, DETROIT, MI 48205-3762
(248) 995-5410
Mailing address
26026 TELEGRAPH RD STE 200, SOUTHFIELD, MI 48033-2560

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
320700000X
Physical Disabilities Residential Treatment Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
385H00000X
Respite Care

Other

Enumeration date
04/22/2025
Last updated
04/22/2025
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