Organization
NORTHEAST GUIDANCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRINA DIXON (CEO)
(313) 824-8000
Entity
Organization
Contact information
Practice address
12800 E WARREN AVE, DETROIT, MI 48215-2061
(313) 824-8000
(313) 824-5589
Mailing address
12800 E WARREN AVE, DETROIT, MI 48215-2061
(313) 824-8000
(313) 824-5589
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
R 120744734409
MI
Other
Enumeration date
01/16/2009
Last updated
01/16/2009
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