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Organization
CHILD AND YOUNG ADULT RESOURCE CENTER
Active
Organization
CHILD AND YOUNG ADULT RESOURCE CENTER
Active
Other names
PHYLLIS GRUBER CHILD AND YOUNG ADULT RESOURCE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
FRED H GRUBER (OWNER)
(734) 552-8539
Entity
Organization
Contact information
Practice address
3804 HAZEL AVE, LINCOLN PARK, MI 48146-3739
(734) 552-8539
Mailing address
3804 HAZEL AVE, LINCOLN PARK, MI 48146-3739
(734) 552-8539
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
11/02/2023
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