Individual provider · Type 1 NPI
Kissie Shanta Washington
Child Intellectual and/or Developmental Disabilities Respite Care · Detroit, MI
NPI number
1306294707
Active
Practice location
15476 Archdale St
Detroit, MI 48227-1506
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | None listed |
| Child Intellectual and/or Developmental Disabilities Respite Care | 385HR2060X | None listed |
| Other Technician | 247200000X | None listed |
| Child Intellectual and/or Developmental Disabilities Respite Care Primary | 385HR2060X | None listed |
| Child Physical Disabilities Respite Care | 385HR2065X | None listed |
| Child Mental Illness Respite Care | 385HR2055X | None listed |
| Child Physical Disabilities Respite Care | 385HR2065X | None listed |
| Child Mental Illness Respite Care | 385HR2055X | None listed |
Child Intellectual and/or Developmental Disabilities Respite Care: A facility or distinct part of a facility that provides short term, residential care to children diagnosed with intellectual and/or developmental disabilities as respite for the regular caregivers.
Another provider at this address
About NPI 1306294707
Kissie Shanta Washington's National Provider Identifier is 1306294707, issued on May 26, 2016. The primary taxonomy on file is Child Intellectual and/or Developmental Disabilities Respite Care (385HR2060X), and the practice location is in Detroit, MI. The record was last updated on Sep 29, 2026.