Organization
DOWRIVER'S NEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN BARNETT LMSW (BUSINESS MANAGER)
(313) 292-5300
Entity
Organization
Contact information
Practice address
24354 ECORSE RD., TAYLOR, MI 48180
(313) 292-5300
(313) 633-9896
Mailing address
24354 ECORSE RD., TAYLOR, MI 48180
(313) 292-5300
(313) 633-9896
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
6801087071
MI
Other
Enumeration date
02/18/2013
Last updated
02/18/2013
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