Organization
ELEANOR MARIE QUALLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELEANOR MARIE QUALLS (CEO/PRESIDENT)
(313) 618-6254
Entity
Organization
Contact information
Practice address
20314 FENMORE ST, DETROIT, MI 48235-2294
(313) 618-6254
Mailing address
20314 FENMORE ST, DETROIT, MI 48235-2294
(313) 618-6254
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6802070438
MI
Other
Enumeration date
09/07/2007
Last updated
05/07/2008
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