Organization
HEALING HOUSE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE GRAVES LMSW (CEO/OWNER)
(313) 717-4898
Entity
Organization
Contact information
Practice address
4777 E OUTER DR, DETROIT, MI 48234-3241
(313) 717-4898
Mailing address
965 RAVINE TERRACE CT, ROCHESTER HILLS, MI 48307-2720
(313) 717-4898
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801106711
BOARD OF SOCIAL WORK
MI
Enumeration date
08/19/2020
Last updated
08/20/2020
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