Organization
SALVATION ARMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CYNTHIA MAINVILLE (ADMINSTRATOR)
(313) 361-6136
Entity
Organization
Contact information
Practice address
3737 LAWTON ST, DETROIT, MI 48208-2500
(313) 361-6136
(313) 361-6211
Mailing address
3737 LAWTON ST, DETROIT, MI 48208-2500
(313) 361-6136
(313) 361-6211
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
SA0820103
MI
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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