Organization
MY BELOVED GROUP HOME
Active
Other names
My Beloved Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESSA ANTIONETTE NELSON (ADMINISTRATOR)
(248) 470-0063
Entity
Organization
Contact information
Practice address
24260 RADCLIFT ST, OAK PARK, MI 48237-1558
(248) 470-0063
(248) 565-8527
Mailing address
24260 RADCLIFT ST, OAK PARK, MI 48237-1558
(248) 470-0063
(248) 565-8527
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
AS630309555
MI
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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