NPI 1013217660

Emanuel T. Vanbolden, PHD, LP, PC

Organisation Community/Behavioral Health Agency Detroit, MI

Practice location

Address: 60 Farnsworth St, Detroit, MI 48202-4060
Phone: (313) 577-2840
Fax: (313) 577-8949
Mailing address: 42335 Woodward Ave, Bloomfield Hills, MI 48304-5040

Authorised official

Name: Emanuel T. Vanbolden
Title: Owner
Phone: (248) 333-1083

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence 6301013909 (MI)

Other Community/Behavioral Health providers in Michigan →

Registry record

NPI: 1013217660
Entity type: Organization
NPI issued: 29 Oct 2010
Record last updated: 29 Oct 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.