Organization Name: | PDHCRC, INC. |
NPI Number: | 1164569802 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BARBARA EMILY FREYSINGER (EXECUTIVE DIRECTOR) |
Mailing Address: | 205 17th St Jackson |
State: | MI US |
Postal Code: | 492031403 |
Phone Number: | 5177844426 |
Fax Number: | |
NPI Enumeration Date: | 01/31/2007 |
NPI Last Update Date: | 06/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320600000X |
License Number: | AL380007055 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |