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General NPI Number Information
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NPI Number | 1427953769
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Entity Type | Organization
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Legal Business Name | B & L SURVIVORS OF RAPE NETWORK
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 29788 GEORGETOWN DR
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City | CHESTERFIELD
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State | MI
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Zip | 48051-2123
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Country | US
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Telephone | 734-444-9656
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Fax |
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Provider Business Mailing Address
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Address Line | 29788 GEORGETOWN DR
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City | CHESTERFIELD
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State | MI
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Zip | 48051-2123
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Country | US
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Telephone | 734-444-9656
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Fax |
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Authorized Official
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Title or Position | CEO AND FOUNDER
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Name | BRANDY IRENE JACOBS
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Credential |
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Telephone | 734-444-9656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State | NULL
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