Healthcare Provider Details

I. General information

NPI: 1346866167
Provider Name (Legal Business Name): GOD'S PATH COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 06/17/2020
Certification Date: 06/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 LEMAY ST
DETROIT MI
48214-3146
US

IV. Provider business mailing address

1728 SHERIDAN ST
DETROIT MI
48214-2410
US

V. Phone/Fax

Practice location:
  • Phone: 313-473-9573
  • Fax:
Mailing address:
  • Phone: 313-676-3271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LORIE ANN TURNER
Title or Position: CEO/FAMILY NURSE PRACTITIONER
Credential: APRN
Phone: 313-473-9573