23D2206881 CLIA NUMBER - WILLIAMS COMMUNITY LIVING

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Laboratory Demographics

CLIA Number: 23D2206881

Facility Name: WILLIAMS COMMUNITY LIVING

Facility Address:
2662 W GRAND BOULEVARD
DETROIT, MI
ZIP 48208
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Facility Phone Number: 313 871-7542

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1356424832

Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

CLIA Record

Field Name	Field Value
CLIA Number	23D2206881
LAB Type	Assisted Living Facility
Facility Name	WILLIAMS COMMUNITY LIVING
Street	2662 W GRAND BOULEVARD
City	DETROIT
State	MI
ZIP	48208
Phone	313 871-7542
CertificateType	4
CertificateEffectiveDate	12/22/2022
CertificateExpirationDate	12/21/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024