| Goodwill Industries Of Greater Detroit | |
|
3111 Grand River Ave Detroit MI 48208-2962 | |
| (313) 964-3900 | |
| (313) 964-3909 |
| Full Name | Goodwill Industries Of Greater Detroit |
|---|---|
| Speciality | Case Manager/care Coordinator |
| Location | 3111 Grand River Ave, Detroit, Michigan |
| Authorized Official Name and Position | Lorna G Utley (PRESIDENT AND CEO) |
| Authorized Official Contact | 3135578787 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Goodwill Industries Of Greater Detroit 3111 Grand River Ave Detroit MI 48208-2962 Ph: (313) 964-3900 | Goodwill Industries Of Greater Detroit 3111 Grand River Ave Detroit MI 48208-2962 Ph: (313) 964-3900 |
| NPI Number | 1548358245 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 03/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548358245 | NPI | - | NPPES |
| 2783305 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Primary |
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