Individual provider · Type 1 NPI
Larry J. Graham Jr.
Mental Illness Community Based Residential Treatment Facility · Pontiac, MI
NPI number
1710528617
Active
Practice location
1284 Maurer Ave
Pontiac, MI 48342-1960
Mailing address
1225 E Big Beaver Rd
Troy, MI 48083-1905
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | None listed |
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.
About NPI 1710528617
Larry J. Graham Jr.'s National Provider Identifier is 1710528617, issued on Oct 1, 2019. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Pontiac, MI. The record was last updated on Oct 1, 2019.