Healthcare Provider Details

I. General information

NPI: 1285731356
Provider Name (Legal Business Name): SMITH AND SMITH MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8891 LITTLEFIELD ST
DETROIT MI
48228-2545
US

IV. Provider business mailing address

8891 LITTLEFIELD ST
DETROIT MI
48228-2545
US

V. Phone/Fax

Practice location:
  • Phone: 313-231-3883
  • Fax: 313-933-2160
Mailing address:
  • Phone: 313-231-3883
  • Fax: 313-933-2160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number1767519
License Number StateMI

VIII. Authorized Official

Name: MR. JOEY SMITH
Title or Position: CEO
Credential:
Phone: 313-231-3883