Provider Demographics
NPI:1902525165
Name:HAVILAH HUMAN SERVICES
Entity Type:Organization
Organization Name:HAVILAH HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER/THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ADIJAT
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNYEMI
Authorized Official - Suffix:
Authorized Official - Credentials:DSW, LMSW
Authorized Official - Phone:248-792-8161
Mailing Address - Street 1:32455 W 12 MILE RD UNIT 3277
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48333-7153
Mailing Address - Country:US
Mailing Address - Phone:248-792-8161
Mailing Address - Fax:
Practice Address - Street 1:42 WEST WARREN AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:248-792-8161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty