Healthcare Provider Details

I. General information

NPI: 1891825808
Provider Name (Legal Business Name): NEIGHBORHOOD SERVICE ORGANIZATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 04/15/2020
Certification Date: 04/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

882 OAKMAN BLVD STE. C
DETROIT MI
48238-3710
US

IV. Provider business mailing address

882 OAKMAN BLVD STE. C
DETROIT MI
48238-3710
US

V. Phone/Fax

Practice location:
  • Phone: 313-961-4890
  • Fax: 313-867-3675
Mailing address:
  • Phone: 313-961-4890
  • Fax: 313-867-3675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateMI

VIII. Authorized Official

Name: LINDA JOYCE LITTLE
Title or Position: PRESIDENT & CEO
Credential:
Phone: 313-961-4890