Organization
ACTIVATING TRANSITIONS CAREGIVERS AND COMPANIONS
Active
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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