Organization
LIFE & DESTINY BUILDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOREEN I BETHEL (/OWNER/CEO)
(248) 721-1526
Entity
Organization
Contact information
Practice address
19400 JOY RD, DETROIT, MI 48228-3035
(248) 721-1526
Mailing address
29460 STELLAMAR DR, SOUTHFIELD, MI 48076-5272
(248) 721-1526
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Enumeration date
09/28/2010
Last updated
09/28/2010
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