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Community/Behavioral Health in Dearborn, MI. Organization (NPI-2).

NPI number1215366646
StatusActive
Last updated in NPPESNov 6, 2013

Details

NPI
1215366646
Entity type
Organization (NPI-2)
Legal business name
Access
Organization subpart
No
Enumeration date
Nov 6, 2013
Last updated
Nov 6, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health6801083912MIYes

Practice location

2651 Saulino Ct
Dearborn, MI 48120-1556

Phone 313-842-7010 · Fax 313-842-5150

Mailing address

6451 Schaefer Rd
Dearborn, MI 48126-2212

Authorized official

Hakeem Lummuba
Clinical Dirctor
3139458138

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