Provider First Line Business Practice Location Address:
25501 VAN DYKE AVE
Provider Second Line Business Practice Location Address:
LIFELINE PSYCHIATRIC SERVICES
Provider Business Practice Location Address City Name:
CENTER LINE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48015-1208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-755-8911
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/26/2015