Organization
IMANI RESIDENTIAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH GRIZZARD (EXECUTIVE DIRECTOR)
(313) 350-7390
Entity
Organization
Contact information
Practice address
23480 RENSSELAER ST, OAK PARK, MI 48237-2151
(313) 350-7390
(248) 552-9524
Mailing address
23480 RENSSELAER ST, OAK PARK, MI 48237-2151
(313) 350-7390
(248) 552-9524
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/18/2006
Last updated
08/22/2020
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