Organization
HEGIRA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANTAVIUS BUCKNER (CASE MANAGER)
(734) 624-7941
Entity
Organization
Contact information
Practice address
37450 SCHOOLCRAFT RD, LIVONIA, MI 48150-1082
(734) 458-4601
Mailing address
37450 SCHOOLCRAFT RD, LIVONIA, MI 48150-1082
(734) 458-4601
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/27/2015
Last updated
08/27/2015
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