IndividualActive
Larry Graham
NPI 1710528617 · Mental Illness Community Based Residential Treatment Facility · Pontiac, MI
Provider details
- NPI number
- 1710528617
- Entity type
- Individual
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Practice location
1284 Maurer Ave
Pontiac, MI 48342-1960
Phone: (248) 252-1427
Approximate (ZIP-level) locationGet directions
Mailing address
1225 E Big Beaver Rd
Troy, MI 48083-1905
Registry dates
- Enumerated
- 2019-10-01
- Last updated
- 2019-10-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.