IndividualActive
Harold Rudolph
NPI 1346588076 · Mental Illness Community Based Residential Treatment Facility · Detroit, MI
Provider details
- NPI number
- 1346588076
- Entity type
- Individual
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
- License
- 820174 (MI)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
1852 W Grand Blvd
Detroit, MI 48208-1006
Phone: (313) 894-8444
Fax: (313) 894-5542
Approximate (ZIP-level) locationGet directions
Mailing address
1852 W Grand Blvd
Detroit, MI 48208-1006
Registry dates
- Enumerated
- 2013-01-31
- Last updated
- 2013-01-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.