Organization
PURE RECOVERY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP SIMMONS LPC (PROGRAM DIRECTOR)
(313) 231-6049
Entity
Organization
Contact information
Practice address
19406 NORWOOD ST, DETROIT, MI 48234-1870
(313) 231-6049
Mailing address
20490 HARPER AVE, SUITE 113, HARPER WOODS, MI 48225-1645
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
823101
MI
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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