Basic Information
| Provider Information | |||||||||
| NPI: | 1790292928 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | GOLDEN POINT COMMUNITY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6269 POTOMAC CIR | ||||||||
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| City: | WEST BLOOMFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483222125 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484958985 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4777 E OUTER DR | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482343241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484958985 | ||||||||
| FaxNumber: | 2488625665 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2018 | ||||||||
| LastUpdateDate: | 01/09/2019 | ||||||||
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| AuthorizedOfficialLastName: | CARTER | ||||||||
| AuthorizedOfficialFirstName: | KARICIA | ||||||||
| AuthorizedOfficialMiddleName: | REGENE | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2484958985 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3104A0625X | N | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness | 324500000X | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.