LIONEL ROSS BASS

DETROIT, MI
NPI1336353838
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2007-05-10
Last Update Date2007-07-08
Business Address
Mr. LIONEL ROSS BASS FAODP
2081 W GRAND BLVD
DETROIT, MI 48208-1105
Phone number: 313-895-0500
Mailing Address
Mr. LIONEL ROSS BASS FAODP
3655 RIVARD ST APT 6
DETROIT, MI 48207-2039
Phone number: 313-833-0229