Organization
SALVATION ARMY-HARBOR LIGHT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE GATES (QA)
(313) 361-6136
Entity
Organization
Contact information
Practice address
3737 LAWTON ST, DETROIT, MI 48208-2500
(313) 361-6136
(313) 361-6210
Mailing address
3737 LAWTON ST, DETROIT, MI 48208-2500
(313) 361-6136
(313) 361-6210
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
4301061866
MI
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4701194
—
MI
Enumeration date
09/20/2006
Last updated
10/10/2024
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