Organization
CHILD AND YOUNG ADULT RESOURCE CENTER
Active
Other names
PHYLLIS GRUBER CHILD AND YOUNG ADULT RESOURCE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
FRED H GRUBER (OWNER)
(734) 552-8539
Entity
Organization
Contact information
Practice address
3804 HAZEL AVE, LINCOLN PARK, MI 48146-3739
(734) 552-8539
Mailing address
3804 HAZEL AVE, LINCOLN PARK, MI 48146-3739
(734) 552-8539
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
11/02/2023
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