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Organization

ALL WELL-BEING SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DAWN RUCKER LMSW (PRESIDENT & CEO)
(313) 924-7860
Entity
Organization

Contact information

Practice address
1423 FIELD ST, DETROIT, MI 48214
(313) 924-7860
(313) 924-0350
Mailing address
1423 FIELD ST, DETROIT, MI 48214-2321
(313) 924-7860
(313) 924-0350

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MI
208D00000X
General Practice Physician
251B00000X
Case Management Agency
251C00000X
Developmentally Disabled Services Day Training Agency
251S00000X
Community/Behavioral Health Agency
261QP2300X
Primary Care Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0Q26261
BLUE CROSS BLUE SHIELD
MI
01
0Q26419
BLUE CROSS & BLUE SHIELD
MI
05
1706562
MI
Enumeration date
10/13/2006
Last updated
06/08/2018
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