Provider Demographics
NPI:1679048870
Name:NEIGHBORHOOD LIVING SERVICES,INC.
Entity Type:Organization
Organization Name:NEIGHBORHOOD LIVING SERVICES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARLOWE
Authorized Official - Suffix:II
Authorized Official - Credentials:MASTERS OF EDUCATION
Authorized Official - Phone:313-535-0601
Mailing Address - Street 1:23001 NORFOLK ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-1185
Mailing Address - Country:US
Mailing Address - Phone:313-535-0601
Mailing Address - Fax:
Practice Address - Street 1:23001 NORFOLK ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-1185
Practice Address - Country:US
Practice Address - Phone:313-535-0601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness