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Organization
DOMINION ADULT DAY CARE AND THERAPEUTIC CLINIC
Active
Organization
DOMINION ADULT DAY CARE AND THERAPEUTIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BILLIE R SMITH (PARTNER)
(313) 586-2249
Entity
Organization
Contact information
Practice address
12601 E CANFIELD ST, DETROIT, MI 48215-2210
(313) 586-2249
Mailing address
12601 E CANFIELD ST, DETROIT, MI 48215-2210
(313) 586-2249
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801020767
MI
Other
Enumeration date
10/07/2014
Last updated
05/20/2015
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