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Mr. Larry J Graham JR.
Mental Illness Community Based Residential Treatment Facility in Pontiac, Michigan
NPI 1710528617

Larry J Graham JR. is a Mental Illness Community Based Residential Treatment Facility based in Troy, MI. Larry J Graham JR. practices in Pontiac, MI. The NPI Number for Larry J Graham JR. is 1710528617 and holds a License No. (Michigan).

The current practice location address for Larry J Graham JR. is 1284 Maurer Ave, Pontiac, MI and can be reached out via phone at 248-252-1427.

Location: 1284 Maurer Ave, Pontiac, MI, 48083-1905
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1710528617
Provider Name
Larry J Graham JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
1284 Maurer Ave, Pontiac, MI, 48083-1905
Phone Number
248-252-1427
Fax Number
Provider Enumeration Date
10/01/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1284 Maurer Ave
City
Pontiac
State
Michigan
Zip
48342-1960
Phone Number
248-252-1427
Fax Number
person
Provider Business Mailing Address Details
Address
1284 Maurer Ave
City
Pontiac
State
Michigan
Zip
48342-1960
Phone Number
248-252-1427
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
()
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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