Organization
CIRCLE OF LIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DOLORES MATTOX R.N. (REGISTERED NURSE)
(248) 545-7086
Entity
Organization
Contact information
Practice address
24080 SENECA ST, OAK PARK, MI 48237-3725
(248) 545-7086
Mailing address
24080 SENECA STREET, OAK PARK, MI 48237
(248) 545-7086
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
4704125356
MI
Other
Enumeration date
03/07/2007
Last updated
08/22/2020
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