Individual provider · Type 1 NPI

Harold Alphonso Rudolph

Mental Illness Community Based Residential Treatment Facility · Detroit, MI

NPI number 1346588076 Active

Practice location

1852 W Grand Blvd
Detroit, MI 48208-1006

Call (313) 894-8444 Map

Fax (313) 894-5542

Specialties and licenses

TaxonomyCodeLicense
Mental Illness Community Based Residential Treatment Facility Primary 320800000X820174 (MI)

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

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About NPI 1346588076

Harold Alphonso Rudolph's National Provider Identifier is 1346588076, issued on Jan 31, 2013. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Detroit, MI. The record was last updated on Jan 31, 2013.