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Organization
MOSAIC MISSION
Active
Organization
MOSAIC MISSION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY D KELLER (OWNER)
(734) 972-5679
Entity
Organization
Contact information
Practice address
2927 GLENBROKE ST, KEEGO HARBOR, MI 48320-1102
(734) 972-5679
Mailing address
2927 GLENBROKE ST, KEEGO HARBOR, MI 48320-1102
(734) 972-5679
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/15/2019
Last updated
10/09/2019
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