Organization
CARE CREST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERICA GIVANS (HEALTHCARE ADMINISTRATOR)
(313) 421-9835
Entity
Organization
Contact information
Practice address
15365 HILL CT, ROSEVILLE, MI 48066-3119
(586) 879-0114
Mailing address
15365 HILL CT, ROSEVILLE, MI 48066-3119
(586) 879-0114
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
632127
MI
Other
Enumeration date
09/17/2015
Last updated
01/11/2016
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