Organization
ALLIANCENET
Active
Other names
Incident Management Team
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH L WOLF PH.D. (DIRECTOR)
(248) 217-1677
Entity
Organization
Contact information
Practice address
6330 BLOOMFIELD GLENS RD, WEST BLOOMFIELD, MI 48322-2513
(248) 217-1677
(248) 626-3759
Mailing address
6330 BLOOMFIELD GLENS RD, WEST BLOOMFIELD, MI 48322-2513
(248) 217-1677
(248) 626-3759
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6301002014
MI
Other
Enumeration date
12/14/2010
Last updated
09/21/2015
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