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Organization

YOUR GOODVILLAGE COLLECTIVE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ANJANETTE DAVENPORT HATTER LMSW (FOUNDING EXECUTIVE DIRECTOR)
(313) 510-7003
Entity
Organization

Contact information

Practice address
12811 HEMINGWAY, REDFORD, MI 48239-4606
(888) 357-2366
(888) 357-2366
Mailing address
12811 HEMINGWAY, REDFORD, MI 48239-4606
(313) 510-7003

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
251K00000X
Public Health or Welfare Agency
Primary
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
03/30/2021
Last updated
04/06/2021
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