Organization
LIFE CENTER MIHP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL LYN COPELAND LLMSW (OWNER)
(313) 704-4837
Entity
Organization
Contact information
Practice address
20245 PICADILLY RD, DETROIT, MI 48221-1308
(313) 704-4837
Mailing address
20245 PICADILLY RD, DETROIT, MI 48221-1308
(313) 704-4837
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
02/16/2012
Last updated
02/16/2012
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