Healthcare Provider Details

I. General information

NPI: 1205854916
Provider Name (Legal Business Name): DETROIT EAST, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11457 SHOEMAKER ST
DETROIT MI
48213-3418
US

IV. Provider business mailing address

11457 SHOEMAKER ST
DETROIT MI
48213-3418
US

V. Phone/Fax

Practice location:
  • Phone: 313-331-3435
  • Fax: 313-921-4125
Mailing address:
  • Phone: 313-331-3435
  • Fax: 313-921-4125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MARILYN SNOWDEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LMSW
Phone: 313-331-3435