# GRATIOT ADVANCED CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598242455
- **Authorized official:** MS. LAKEISHA WILLIAMS (OFFICE MANAGER)
- **Authorized official phone:** (313) 924-8994

## Contact information

- **Practice address:** 7612 GRATIOT AVE STE 200, DETROIT, MI 48213-2822
- **Practice address phone:** (313) 924-8994
- **Practice address fax:** (313) 924-8990
- **Mailing address:** 7612 GRATIOT AVE STE 200, DETROIT, MI 48213-2822
- **Mailing address phone:** (313) 924-8994
- **Mailing address fax:** (313) 924-8990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/24/2018
- **Last updated:** 11/02/2018