NPI | 1225254279 |
---|---|
Doing Business As | FUNDERBURG CCS |
Entity Type | Organization |
Authorized Contact | GERALD RODERICK FUNDERBURG Owner 248-809-9105 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801086140) |
Enumeration Date | 2007-04-18 |
Last Update Date | 2009-09-11 |