NPI 1841577103

My Beloved Group Home

Organisation Mental Illness Community Based Residential Treatment Facility Oak Park, MI

Practice location

Address: 24260 Radclift St, Oak Park, MI 48237-1558
Phone: (248) 470-0063
Fax: (248) 565-8527

Authorised official

Name: Theressa Antionette Nelson
Title: Administrator
Phone: (248) 470-0063

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence AS630309555 (MI)

Other Community Based Residential Treatment Facility, Mental Illness providers in Michigan →

Registry record

NPI: 1841577103
Entity type: Organization
NPI issued: 14 Nov 2011
Record last updated: 14 Nov 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.