Organization
ACTIVATING TRANSITIONS CAREGIVERS AND COMPANIONS
Active
Other names
Latisha Blackwell
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LATISHA BLACKWELL (OWNER/EXECUTIVE DIRECTOR)
(313) 138-2820
Entity
Organization
Contact information
Practice address
58 HILL ST, RIVER ROUGE, MI 48218-1537
(313) 828-2058
Mailing address
58 HILL ST, RIVER ROUGE, MI 48218-1537
(313) 828-2058
(313) 828-2058
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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