Organization
LOGICAL CHOICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIETRIC JENKINS (PROGRAM DIRECTOR)
(313) 643-5542
Entity
Organization
Contact information
Practice address
5575 CONNER ST., SUITE 210, DETROIT, MI 48213-6400
(313) 643-5542
(248) 522-7045
Mailing address
5575 CONNER ST., SUITE 210, DETROIT, MI 48213-6400
(313) 643-5542
(248) 522-7045
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
12/23/2011
Last updated
12/23/2011
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