Provider Demographics
NPI:1437235140
Name:PATRICK DEVELOPMENT INC
Entity Type:Organization
Organization Name:PATRICK DEVELOPMENT INC
Other - Org Name:THE PATRICK CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HOME PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-341-2827
Mailing Address - Street 1:19301 SORRENTO
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235
Mailing Address - Country:US
Mailing Address - Phone:313-341-2827
Mailing Address - Fax:248-681-4631
Practice Address - Street 1:19301 SORRENTO ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-1233
Practice Address - Country:US
Practice Address - Phone:313-341-2827
Practice Address - Fax:248-681-4631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities