Healthcare Provider Details

I. General information

NPI: 1184232746
Provider Name (Legal Business Name): HOW-ADOLESCENT SUBSTANCE ABUSE PROGRAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2020
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2727 2ND AVE STE 212
DETROIT MI
48201-2677
US

IV. Provider business mailing address

2727 2ND AVE STE 212
DETROIT MI
48201-2677
US

V. Phone/Fax

Practice location:
  • Phone: 313-778-4524
  • Fax:
Mailing address:
  • Phone: 313-778-4524
  • Fax:

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 Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: GREGORY FRANKLIN
Title or Position: DIRECTOR
Credential:
Phone: 313-778-4524