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Organization
MULTIDIMENSIONS CARE MANAGEMENT
Active
Organization
MULTIDIMENSIONS CARE MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY WILLIS COLSTON LMSW (CEO)
(313) 864-2987
Entity
Organization
Contact information
Practice address
17555 JAMES COUZENS FWY, 2 WEST, DETROIT, MI 48235-2657
(313) 864-2987
(313) 864-2142
Mailing address
17555 JAMES COUZENS FWY, 2-WEST, DETROIT, MI 48235-2657
(313) 864-2987
(313) 864-2142
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801034096
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096642
VALUE OPTIONS PROVIDER #
MI
Enumeration date
12/03/2006
Last updated
08/22/2020
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