Rudolph, Harold Alphonso

Rudolph, Harold Alphonso is an sole proprietor health care provider with primary practice located at 1852 W Grand Blvd , Detroit MI 48208-1006. He recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness, which is considered as his primary health care specialty. Rudolph, Harold Alphonso can be contacted via phone (313) 894-8444.

Contact Information

Primary practice address
1852 W Grand Blvd Detroit MI 48208-1006
Phone: (313) 894-8444
Fax: (313) 894-5542
Website:
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Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Illness 320800000X 820174 Michigan

Profile Details

NPI number 1346588076
LBN Legal business name Rudolph, Harold Alphonso
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 31st, 2013
Last updated Jan 31st, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346588076 NPPES
Michigan MEDICAID 381917278

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