Organization
ST JOHN PROVIDENCE EASTWOOD CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD HEALY LMSW, CAADC, ACSW (SUPERVISOR)
(313) 369-5508
Entity
Organization
Contact information
Practice address
4777 E OUTER DR STE 1105, DETROIT, MI 48234-3241
(313) 369-5508
Mailing address
4777 E OUTER DR STE 1105, DETROIT, MI 48234-3241
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/23/2012
Last updated
08/23/2012
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