Healthcare Provider Details

I. General information

NPI: 1134477284
Provider Name (Legal Business Name): TOGETHER WE RE-ESTBLISH UNITY SAFETY & TOGETHERNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2012
Last Update Date: 08/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 BRIMFIELD DRIVE
FLINT MI
48503
US

IV. Provider business mailing address

3415 BRIMFIELD DR
FLINT MI
48503-2944
US

V. Phone/Fax

Practice location:
  • Phone: 810-742-7230
  • Fax:
Mailing address:
  • Phone: 810-742-7230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License NumberAS250292392
License Number StateMI

VIII. Authorized Official

Name: MONICA LYNETTE LEE-GIVENS
Title or Position: CEO
Credential:
Phone: 810-449-7081