Provider Demographics
NPI:1366785032
Name:REHABILITATIVE COUNSELING AND BEHAVIORAL SERVICES OF AMERICA
Entity type:Organization
Organization Name:REHABILITATIVE COUNSELING AND BEHAVIORAL SERVICES OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:LLPC
Authorized Official - Phone:586-443-6543
Mailing Address - Street 1:33800 GROESBECK HWY
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-3970
Mailing Address - Country:US
Mailing Address - Phone:586-533-5738
Mailing Address - Fax:
Practice Address - Street 1:33800 GROESBECK HWY
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-3970
Practice Address - Country:US
Practice Address - Phone:586-533-5738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013502251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health