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General NPI Number Information
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NPI Number | 1902525165
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Entity Type | Organization
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Legal Business Name | HAVILAH HUMAN SERVICES
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 42 WEST WARREN AVE
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone | 248-792-8161
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Fax |
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Provider Business Mailing Address
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Address Line | 32455 W 12 MILE RD UNIT 3277
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City | FARMINGTON
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State | MI
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Zip | 48333-7153
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Country | US
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Telephone | 248-792-8161
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER/THERAPIST
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Name | DR. ADIJAT OGUNYEMI
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Credential | DSW, LMSW
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Telephone | 248-792-8161
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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 |
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License Number State |
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