Organization
POINT A ORGANIZATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATOYA MARIE MOBLEY SST BS MCD (EXECUTIVE DIRECTOR)
(313) 971-4625
Entity
Organization
Contact information
Practice address
12091 CLOVERLAWN ST, DETROIT, MI 48204-1012
(313) 971-4625
(313) 307-8728
Mailing address
12091 CLOVERLAWN ST, DETROIT, MI 48204-1012
(313) 971-4625
(313) 307-8728
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041S0200X
School Social Worker
—
—
163WC0400X
Case Management Registered Nurse
—
—
163WD0400X
Diabetes Educator Registered Nurse
—
—
163WN1003X
Nutrition Support Registered Nurse
—
—
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
—
—
163WW0101X
Ambulatory Women's Health Care Registered Nurse
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/24/2017
Last updated
06/20/2018
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