Organization
LIFE TRANSITION SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GENE JUDD PMHNP-BC (OWNER)
(586) 663-8906
Entity
Organization
Contact information
Practice address
21031 SUNNYDALE, ST. CLAIR SHORE, MI 48081
(586) 663-8906
Mailing address
21031 SUNNYDALE, ST. CLAIR SHORE, MI 48081
(586) 663-8906
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
47041996416
MI
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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