Organization
GENERATIONAL COMMUNITY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA VINSON (ADMINSTRATOR)
(313) 656-7105
Entity
Organization
Contact information
Practice address
15510 THATCHER ST, DETROIT, MI 48235-3122
(313) 656-7105
Mailing address
15510 THATCHER ST, DETROIT, MI 48235-3122
(313) 656-7105
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
106S00000X
Behavior Technician
—
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
Primary
—
—
174H00000X
Health Educator
—
—
221700000X
Art Therapist
—
—
372500000X
Chore Provider
—
—
Other
Enumeration date
09/14/2021
Last updated
09/14/2021
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