Organization
BREAKING THE CHAIN COUNSELING CTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD SMITH (OWNER)
(810) 494-7160
Entity
Organization
Contact information
Practice address
774 W GRAND RIVER AVE, BRIGHTON, MI 48116-2392
(810) 494-7160
Mailing address
774 W GRAND RIVER AVE, BRIGHTON, MI 48116-2392
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
470094
MI
Other
Enumeration date
06/10/2013
Last updated
06/10/2013
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