Provider Demographics
NPI:1457826315
Name:NORTHROP LOVING CARE
Entity Type:Organization
Organization Name:NORTHROP LOVING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ECO
Authorized Official - Prefix:
Authorized Official - First Name:ZATTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-727-3229
Mailing Address - Street 1:17777 NORTHROP ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-2321
Mailing Address - Country:US
Mailing Address - Phone:313-727-3239
Mailing Address - Fax:313-740-7329
Practice Address - Street 1:17777 NORTHROP ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-2321
Practice Address - Country:US
Practice Address - Phone:313-727-3239
Practice Address - Fax:313-740-7329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities