Organization
BRANMIRA'S HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES R WATSON (IT MANAGER)
(313) 538-8273
Entity
Organization
Contact information
Practice address
17290 SHAFTSBURY AVE, DETROIT, MI 48219-3591
(313) 538-8273
(313) 538-8273
Mailing address
17290 SHAFTSBURY AVE, DETROIT, MI 48219-3591
(313) 538-8273
(313) 538-8273
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
AS820295652
MI
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
AS820295652
MI
311ZA0620X
Adult Care Home Facility
Primary
AS820295652
MI
Other
Enumeration date
07/25/2011
Last updated
07/25/2011
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