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General NPI Number Information
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NPI Number | 1679663546
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Entity Type | Organization
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Legal Business Name | ALL WELL-BEING SERVICES
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 06/08/2018
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Provider Practice Location Address
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Address Line | 1423 FIELD ST
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City | DETROIT
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State | MI
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Zip | 48214
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Country | US
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Telephone | 313-924-7860
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Fax | 313-924-0350
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Provider Business Mailing Address
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Address Line | 1423 FIELD ST
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City | DETROIT
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State | MI
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Zip | 48214-2321
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Country | US
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Telephone | 313-924-7860
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Fax | 313-924-0350
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MS. DAWN RUCKER
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Credential | LMSW
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Telephone | 313-924-7860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | MI
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