Organization
EXEC-U-TECH BEHAVIORAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AURELIA LAFAYE KENT LLMSW (EXECUTIVE DIRECTOR)
(313) 475-0283
Entity
Organization
Contact information
Practice address
505 BEECHWOOD ST, RIVER ROUGE, MI 48218-1041
(313) 386-2288
Mailing address
1804 CAMPAU FARMS CIR, DETROIT, MI 48207-5164
(313) 475-0283
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6801091303
MI
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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