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NPI 1922442607 · Intellectual Disabilities Intermediate Care Facility · Detroit, MI
Provider details
- NPI number
- 1922442607
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Antonio Ball, Provider(313) 657-4282
- License
- AS820083566 (MI)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
16131 Linwood St
Detroit, MI 48221-3122
Phone: (313) 345-3199
Fax: (313) 345-3610
Approximate (ZIP-level) locationGet directions
Mailing address
16131 Linwood St
Detroit, MI 48221-3122
Registry dates
- Enumerated
- 2013-04-24
- Last updated
- 2013-04-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.