| Healing House, Llc | |
|
4777 E Outer Dr Detroit MI 48234-3241 | |
| (313) 717-4898 | |
| Not Available |
| Full Name | Healing House, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4777 E Outer Dr, Detroit, Michigan |
| Authorized Official Name and Position | Stephanie Graves (CEO/OWNER) |
| Authorized Official Contact | 3137174898 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing House, Llc 965 Ravine Terrace Ct Rochester Hills MI 48307-2720 Ph: (313) 717-4898 | Healing House, Llc 4777 E Outer Dr Detroit MI 48234-3241 Ph: (313) 717-4898 |
| NPI Number | 1154933265 |
|---|---|
| Provider Enumeration Date | 08/19/2020 |
| Last Update Date | 08/20/2020 |
| Certification Date | 08/20/2020 |
| Medicare PECOS PAC ID | 7911325600 |
|---|---|
| Medicare Enrollment ID | O20200911001817 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154933265 | NPI | - | NPPES |
| 6801106711 | Other | MI | BOARD OF SOCIAL WORK |
| Provider Name | Stephanie Te'airra Graves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154850543 PECOS PAC ID: 3173855418 Enrollment ID: I20200331001680 |
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