Organization
JABEZ OP AND TH PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD A ANIAPAM BSC. (PRESIDENT)
(313) 418-7640
Entity
Organization
Contact information
Practice address
7510 DUNEDIN ST # 12, DETROIT, MI 48206-2622
(313) 418-7640
Mailing address
71 RICHTON ST, HIGHLAND PARK, MI 48203-3502
(313) 418-7640
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
822958
MI
Other
Enumeration date
03/21/2007
Last updated
08/22/2020
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