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Organization

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Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANTHONY ELLISON (OWNER)
(313) 465-6864
Entity
Organization

Contact information

Practice address
26005 FRANKLIN POINTE DR, SOUTHFIELD, MI 48034-1568
(313) 465-6864
Mailing address
26005 FRANKLIN POINTE DR, SOUTHFIELD, MI 48034-1568
(313) 465-6864

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
12/28/2015
Last updated
12/28/2015
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