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General NPI Number Information
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NPI Number | 1124146451
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Entity Type | Organization
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Legal Business Name | PASTORAL COUNSELING AND CONSULTATION SERVICE
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 02/05/2018
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Provider Practice Location Address
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Address Line | 24110 CHERRY HILL RD
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City | DEARBORN
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State | MI
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Zip | 48124
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Country | US
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Telephone | 313-274-4510
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Fax | 313-274-4571
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Provider Business Mailing Address
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Address Line | 24110 CHERRY HILL RD
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City | DEARBORN
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State | MI
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Zip | 48124
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Country | US
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Telephone | 313-274-4510
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Fax | 313-274-4571
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROBERT K SEYMOUR
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Credential | REV. DR.
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Telephone | 313-274-4570
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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