Organization
EXECU-TECH MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH A CUMMINGS LMSW,CGP (EXECUTIVE DIRECTOR)
(313) 396-0100
Entity
Organization
Contact information
Practice address
2751 E JEFFERSON AVE, SUITE 500, DETROIT, MI 48207-4180
(313) 396-0100
(313) 396-0105
Mailing address
2751 E JEFFERSON AVE, SUITE 500, DETROIT, MI 48207-4180
(313) 396-0100
(313) 396-0105
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
L796463
MI
Other
Enumeration date
10/28/2006
Last updated
08/22/2020
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