Healthcare Provider Details

I. General information

NPI: 1518615996
Provider Name (Legal Business Name): THE CENTER FOR HOPE AND HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2022
Last Update Date: 03/14/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10496 KINGSTON AVE
HUNTINGTON WOODS MI
48070-1114
US

IV. Provider business mailing address

10496 KINGSTON AVE
HUNTINGTON WOODS MI
48070-1114
US

V. Phone/Fax

Practice location:
  • Phone: 248-534-8880
  • Fax:
Mailing address:
  • Phone: 248-534-8880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. SUSAN ANN DIMARCO
Title or Position: PRACTICE OWNER
Credential: LMSW
Phone: 248-534-8880