Organization · Type 2 NPI

The Great Divine Center LLC

Mental Health Counselor · Detroit, MI

NPI number 1902558091 Active

Practice location

17169 E Warren Ave
Detroit, MI 48224-2279

Call (313) 480-4766 Map

Mailing address

17163 E Warren Ave
Detroit, MI 48224-2279

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed
Community Health Clinic/Center 261QC1500XNone listed
Multi-Specialty Clinic/Center 261QM1300XNone listed

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About NPI 1902558091

The Great Divine Center LLC's National Provider Identifier is 1902558091, issued on Jan 20, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Detroit, MI. The record was last updated on Jan 20, 2022.