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20222 Farmington Rd Livonia MI 48152-1412 | |
| (734) 331-0040 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 20222 Farmington Rd, Livonia, Michigan |
| Authorized Official Name and Position | Grace Gates (OWNER) |
| Authorized Official Contact | 6319420031 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 531302 Livonia MI 48153-1302 Ph: () - | 20222 Farmington Rd Livonia MI 48152-1412 Ph: (734) 331-0040 |
| NPI Number | 1710578604 |
|---|---|
| Provider Enumeration Date | 02/02/2021 |
| Last Update Date | 01/21/2025 |
| Certification Date | 01/21/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710578604 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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