Healthcare Provider Details

I. General information

NPI: 1346498623
Provider Name (Legal Business Name): RELATIONSHIP TIMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2008
Last Update Date: 01/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5582 HOBNAIL CIR
WEST BLOOMFIELD MI
48322-1628
US

IV. Provider business mailing address

5582 HOBNAIL CIR
WEST BLOOMFIELD MI
48322-1628
US

V. Phone/Fax

Practice location:
  • Phone: 248-730-0602
  • Fax:
Mailing address:
  • Phone: 248-730-0602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801080159
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number6801080159
License Number StateMI

VIII. Authorized Official

Name: MRS. ROSEANESTA RODNEZ-SIMPSON
Title or Position: CEO
Credential: LMSW
Phone: 248-730-0602