Organization
OLD REDFORD TREATMENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY FULLER (CEO)
(313) 614-8000
Entity
Organization
Contact information
Practice address
23001 GRAND RIVER AVE, DETROIT, MI 48219-3130
(313) 614-8000
Mailing address
23001 GRAND RIVER AVE, DETROIT, MI 48219-3130
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
09/13/2025
Last updated
11/03/2025
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