# SERVANTS HEART MOBILE MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1669293874
- **Authorized official:** PAULA LORRAINE HESTER (CEO/HEALTHCARE DIRECTOR)
- **Authorized official phone:** (623) 277-7828

## Contact information

- **Practice address:** 15012 PENROD ST, DETROIT, MI 48223-2337
- **Practice address phone:** (623) 277-7828
- **Mailing address:** 25552 SHIAWASSEE RD APT 521, SOUTHFIELD, MI 48033-3708
- **Mailing address phone:** (623) 277-7828

## Taxonomy

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

## Other

- **Enumeration date:** 10/21/2024
- **Last updated:** 10/21/2024