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Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHERYL A DOZIER (CEO/DIRECTOR)
(313) 685-4627
Entity
Organization

Contact information

Practice address
1603 LONGFELLOW ST, DETROIT, MI 48206-2049
(313) 685-4627
Mailing address
1603 LONGFELLOW ST., DETROIT, MI 48206
(313) 685-4627

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
MI
253Z00000X
In Home Supportive Care Agency
Primary
MI

Other

Enumeration date
11/12/2008
Last updated
11/12/2008
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