| NPI | 1245715689 | 
|---|---|
| Former Legal Business Name | LEBANESE AMERICAN HERITAGE CLUB | 
| Entity Type | Organization | 
| Authorized Contact | WASSIM MAHFOUZ Senior Executive Director 313-960-4007  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine | 
| Additional Taxonomies | 251S00000X Community/Behavioral Health | 
| 252Y00000X Early Intervention Provider Agency | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QP0904X Clinic/Center, Public Health, Federal | |
| 261QP0905X Clinic/Center, Public Health, State or Local | |
| Enumeration Date | 2018-10-02 | 
| Last Update Date | 2018-10-02 |