Healthcare Provider Details

I. General information

NPI: 1770488918
Provider Name (Legal Business Name): H.O.D BUSINESS COMMUNITY OUTREACH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 W BUENA VISTA ST
DETROIT MI
48238-3204
US

IV. Provider business mailing address

2785 E GRAND BLVD
DETROIT MI
48211-2003
US

V. Phone/Fax

Practice location:
  • Phone: 313-707-0972
  • Fax:
Mailing address:
  • Phone: 313-707-0972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name: AYESHAH ALBERT
Title or Position: EXECUTIVE DIRECTOR
Credential: M.ED., CHWC
Phone: 248-701-5166