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General NPI Number Information
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NPI Number | 1154771566
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Entity Type | Organization
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Legal Business Name | ETRS(EDUCATION TRAINING RESEARCH SERVICES)
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Dates
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Enumeration Date | 06/16/2016
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Last Update Date | 06/16/2016
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Provider Practice Location Address
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Address Line | 38099 SCHOOLCRAFT RD SUITE 127
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City | LIVONIA
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State | MI
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Zip | 48150-1029
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Country | US
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Telephone | 734-462-3096
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Fax | 734-462-0316
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Provider Business Mailing Address
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Address Line | 25600 WOODWARD AVE SUITE 204
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City | ROYAL OAK
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State | MI
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Zip | 48067-0943
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Country | US
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Telephone | 248-399-2600
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Fax | 248-399-2606
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Authorized Official
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Title or Position | ASSISTANT EXECUTIVE DIRECTOR
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Name | MS. CATHY GITZEN
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Credential | MA
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Telephone | 248-399-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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