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NPI Code Detail

MEDICARE: DETROIT CENTRAL CITY COMMUNITY MENTAL HEALTH, INC

MEDICARE: DETROIT CENTRAL CITY COMMUNITY MENTAL HEALTH, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1447271788
Entity Type Code : Organization
Provider Name (Legal Business Name) : DETROIT CENTRAL CITY COMMUNITY MENTAL HEALTH, INC
Provider Business Mailing Address
First Line : 10 PETERBORO ST
Second Line :
City : DETROIT
State : MI
Zip : 48201-2722
Country : US
Telephone Number : 313-831-3160
Fax Number : 313-826-0567
Provider Business Practice Location Address
First Line : 10 PETERBORO
Second Line :
City : DETROIT
State : MI
Zip : 48201-2722
Country : US
Telephone Number : 313-831-3160
Fax Number : 313-831-2604
Authorized Official
Title or Position : PRESIDENT, CEO
Name : KIMBERLY FARROW
Credential : MD
Telephone Number : 313-831-3160
Provider Enumeration Date : 07/22/2006
Last Update Date : 09/11/2025

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Directions to “DETROIT CENTRAL CITY COMMUNITY MENTAL HEALTH, INC ” Practice Location

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