Organization
GUIDANCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DERRIELLE RENE SMITH LMSW (IDD AUTISM BENEFIT)
(734) 785-7727
Entity
Organization
Contact information
Practice address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
33635 PONDVIEW CIR, LIVONIA, MI 48152-1471
(313) 516-3831
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
6801016587
MI
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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