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General NPI Number Information
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NPI Number | 1467508036
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Entity Type | Organization
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Legal Business Name | LEAN ON ME SERVICES
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 39111 6 MILE RD
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City | LIVONIA
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State | MI
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Zip | 48152-3926
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Country | US
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Telephone | 313-445-8199
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Fax | 313-794-5645
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Provider Business Mailing Address
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Address Line | 17464 FENTON ST
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City | DETROIT
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State | MI
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Zip | 48219-3640
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Country | US
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Telephone | 313-445-8199
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Fax | 313-794-5645
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DAVID GRIFFIN
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Credential | LMSW
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Telephone | 313-445-8199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801082621
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License Number State | MI
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