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NPI 1083857320 · Mental Illness Community Based Residential Treatment Facility · Clinton Township, MI
Provider details
- NPI number
- 1083857320
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Latasha Pemberton, Provider(313) 743-2462
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
24145 Grange St
Clinton Township, MI 48036-3008
Phone: (313) 743-2462
Street-level locationGet directions
Mailing address
24145 Grange St
Clinton Township, MI 48036-3008
Registry dates
- Enumerated
- 2009-04-16
- Last updated
- 2009-04-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.