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General NPI Number Information
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NPI Number | 1831383462
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Entity Type | Organization
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Legal Business Name | EILEEN AVENI, MSW, BCD CORP
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 08/27/2007
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Provider Practice Location Address
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Address Line | 2311 E STADIUM BLVD STE 212
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City | ANN ARBOR
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State | MI
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Zip | 48104-4821
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Country | US
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Telephone | 734-604-0335
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Fax |
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Provider Business Mailing Address
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Address Line | 3035 WASHTENAW AVE # 318
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City | ANN ARBOR
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State | MI
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Zip | 48104-5119
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EILEEN M AVENI
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Credential |
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Telephone | 734-604-0335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6801020495
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License Number State | MI
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