Organization
ST. JOHN PROVIDENCE COMMUNITY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LONNIE HARVEY III (BEHAVIORAL HEALTH COUNSELOR)
(313) 372-5974
Entity
Organization
Contact information
Practice address
11600 E 7 MILE RD, DETROIT, MI 48205-2112
(313) 372-5974
Mailing address
11600 E 7 MILE RD, DETROIT, MI 48205-2112
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
6401013184
MI
Other
Enumeration date
11/05/2015
Last updated
11/18/2015
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