Organization
SUPPORTIVE CARE OF MICHIGAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAPHAEL LICHTSCHEIN (PRESIDENT)
(718) 298-4375
Entity
Organization
Contact information
Practice address
330 LINCOLN AVE, IRON RIVER, MI 49935-8452
(718) 298-2753
Mailing address
27 RANDOLPH RD, HOWELL, NJ 07731-8611
(718) 298-2753
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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