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1518236116
KENNETH DEON BLUE
DETROIT, MI
NPI
1518236116
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
324500000X Substance Abuse Rehabilitation Facility
Enumeration Date
2011-12-28
Last Update Date
2011-12-28
Business Address
-- KENNETH DEON BLUE CADCM
12305 DEXTER AVE
DETROIT, MI 48206-1015
Phone number: 313-397-1306
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Mailing Address
-- KENNETH DEON BLUE CADCM
12305 DEXTER AVE
DETROIT, MI 48206-1015
Phone number: 313-397-1306
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