Healthcare Provider Details

I. General information

NPI: 1245715689
Provider Name (Legal Business Name): LAHC- LEADERS ADVANCING AND HELPING COMMUNITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5275 KENILWORTH ST
DEARBORN MI
48126-3197
US

IV. Provider business mailing address

5275 KENILWORTH ST
DEARBORN MI
48126-3197
US

V. Phone/Fax

Practice location:
  • Phone: 313-846-8480
  • Fax: 313-846-2710
Mailing address:
  • Phone: 313-846-8480
  • Fax: 313-846-2710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QP0905X
TaxonomyState or Local Public Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. WASSIM MAHFOUZ
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 313-960-4007