Provider Demographics
NPI:1558466805
Name:CENTER OF BEHAVIORAL THERAPY P.C.
Entity Type:Organization
Organization Name:CENTER OF BEHAVIORAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HOLLIS
Authorized Official - Middle Name:MILTON
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-592-1765
Mailing Address - Street 1:26847 GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48240-1544
Mailing Address - Country:US
Mailing Address - Phone:313-592-1765
Mailing Address - Fax:313-592-1864
Practice Address - Street 1:26847 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-1544
Practice Address - Country:US
Practice Address - Phone:313-592-1765
Practice Address - Fax:313-592-1864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management