Provider Demographics
NPI:1972542835
Name:ATTITUDE RECOVERY CENTER
Entity type:Organization
Organization Name:ATTITUDE RECOVERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOSS
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:HOMER
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:BS, RSW
Authorized Official - Phone:313-516-5554
Mailing Address - Street 1:32841 AUGUSTA CT
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-6300
Mailing Address - Country:US
Mailing Address - Phone:313-516-5554
Mailing Address - Fax:
Practice Address - Street 1:32841 AUGUSTA CT
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-6300
Practice Address - Country:US
Practice Address - Phone:313-516-5554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI720509103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty