Organization
METRO EAST DRUG TREATMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELORES CLARK (COUNSELOR)
(313) 371-0055
Entity
Organization
Contact information
Practice address
14667 CEDARGROVE ST, DETROIT, MI 48205-3609
(313) 371-0055
(313) 371-1409
Mailing address
14667 CEDARGROVE ST, DETROIT, MI 48205-3609
(313) 371-0055
(313) 371-1409
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
821237
MI
Other
Enumeration date
03/26/2007
Last updated
08/22/2020
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