Organization
CHRISTIAN COVENANT COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW D. HUMPHRIES MSW (MANAGER/OWNER)
(313) 806-6711
Entity
Organization
Contact information
Practice address
5115 GRAYTON ST, DETROIT, MI 48224-2147
(313) 806-6711
(313) 885-5059
Mailing address
5115 GRAYTON ST, DETROIT, MI 48224-2147
(313) 806-6711
(313) 885-5059
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/23/2013
Last updated
02/23/2013
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