| The Great Divine Center Llc | |
|
17169 E Warren Ave Detroit MI 48224-2279 | |
| (313) 480-4766 | |
| Not Available |
| Full Name | The Great Divine Center Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 17169 E Warren Ave, Detroit, Michigan |
| Authorized Official Name and Position | Kymaletha Brown (COUNSELOR/OWNER) |
| Authorized Official Contact | 3134804766 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Great Divine Center Llc 17163 E Warren Ave Detroit MI 48224-2279 Ph: (313) 480-4766 | The Great Divine Center Llc 17169 E Warren Ave Detroit MI 48224-2279 Ph: (313) 480-4766 |
| NPI Number | 1902558091 |
|---|---|
| Provider Enumeration Date | 01/20/2022 |
| Last Update Date | 01/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902558091 | NPI | - | NPPES |
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