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General NPI Number Information
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NPI Number | 1558676791
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Entity Type | Organization
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Legal Business Name | ITS JUST FOR ME CENTER
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 18681 CHERRYLAWN ST
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City | DETROIT
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State | MI
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Zip | 48221-2045
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Country | US
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Telephone | 313-282-5948
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Fax |
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Provider Business Mailing Address
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Address Line | 18681 CHERRYLAWN ST
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City | DETROIT
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State | MI
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Zip | 48221-2045
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Country | US
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Telephone | 313-282-5948
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. DEBORAH F SMITH
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Credential | LLMSW
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Telephone | 313-282-5948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 6801090126
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6801090126
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License Number State | MI
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