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Organization
FUNDERBURG CLINICAL AND COMMUNITY SERVICES
Active
Organization
FUNDERBURG CLINICAL AND COMMUNITY SERVICES
Active
Other names
Funderburg CCS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD RODERICK FUNDERBURG JR. LLMSW M.S.W (OWNER)
(248) 809-9105
Entity
Organization
Contact information
Practice address
25438 SAINT JAMES, SOUTHFIELD, MI 48075-1247
(248) 809-9105
(248) 659-1528
Mailing address
25438 SAINT JAMES, SOUTHFIELD, MI 48075-1247
(248) 809-9105
(248) 659-1528
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801086140
MI
Other
Enumeration date
04/18/2007
Last updated
09/11/2009
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