Goedert Therapeutic Services, LLC
Community/Behavioral Health in Royal Oak, MI. Organization (NPI-2).
NPI number1780944967
StatusActive
Last updated in NPPESMay 22, 2012
Details
- NPI
- 1780944967
- Entity type
- Organization (NPI-2)
- Legal business name
- Goedert Therapeutic Services, LLC
- Organization subpart
- No
- Enumeration date
- May 22, 2012
- Last updated
- May 22, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | 6801089319 | MI | Yes |
Practice location
415 S West StSuite 150
Royal Oak, MI 48067-2521
Phone 313-850-0469
Mailing address
415 S West StSuite 150
Royal Oak, MI 48067-2521
Phone 313-850-0469
Authorized official
Mead Goedert
Clinical Therapist
3138500469
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