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1336353838
LIONEL ROSS BASS
DETROIT, MI
NPI
1336353838
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-05-10
Last Update Date
2007-07-08
Business Address
Mr. LIONEL ROSS BASS FAODP
2081 W GRAND BLVD
DETROIT, MI 48208-1105
Phone number: 313-895-0500
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Mailing Address
Mr. LIONEL ROSS BASS FAODP
3655 RIVARD ST APT 6
DETROIT, MI 48207-2039
Phone number: 313-833-0229
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