Organization
ACCESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAKEEM LUMMUBA (CLINICAL DIRCTOR)
(313) 945-8138
Entity
Organization
Contact information
Practice address
2651 SAULINO CT, DEARBORN, MI 48120-1556
(313) 842-7010
(313) 842-5150
Mailing address
6451 SCHAEFER RD, DEARBORN, MI 48126-2212
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6801083912
MI
Other
Enumeration date
11/06/2013
Last updated
11/06/2013
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