Independent Lifestyle Clubhouse LLC
NPI #1235685694 in Inkster, Michigan
Provider Information
- NPI Number
- 1235685694
- Entity Type
- Organization
- Organization Name
- Independent Lifestyle Clubhouse LLC
- Primary Specialty
- Clinic/Center - Adult Mental Health
- Enumeration Date
- Aug 26, 2016
- Last Updated
- Feb 5, 2019
Practice Location
Authorized Official
- Name
- MRS. SHONDRA LYNN JACKSON
- Title
- DIRECTOR
- Phone
- (313) 622-3287
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Adult Mental Health — Adult Mental Health |
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