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Organization

THE HEALING PALACE INC

Active
Other names
DIVINE INTERVENTIONS
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHONTAY DETRIA TAYLOR GLENN PHD, RN, PMHNP-BC (FOUNDER AND CEO)
(313) 459-6707
Entity
Organization

Contact information

Practice address
2089 ANITA AVE, GROSSE POINTE WOODS, MI 48236-1427
(313) 459-6707
(313) 731-0360
Mailing address
2089 ANITA AVE, GROSSE POINTE WOODS, MI 48236-1427
(313) 459-6707
(313) 731-0360

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
470408682
MI
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
4704208682
MI

Other

Enumeration date
04/16/2008
Last updated
11/04/2022
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