Organization
STREET LIFE RECOVERY PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD IAN ROBINSON PEER SUPPORT (EXECUTIVE DIRECTOR)
(734) 262-2753
Entity
Organization
Contact information
Practice address
14703 ALLEN RD STE 104, SOUTHGATE, MI 48195-2594
(734) 496-5599
Mailing address
14703 ALLEN RD STE 104, SOUTHGATE, MI 48195-2594
(734) 262-2753
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/26/2024
Last updated
08/07/2025
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