Healthcare Provider Details

I. General information

NPI: 1851682215
Provider Name (Legal Business Name): DETROIT RESCUE MISSION MINISTRIES GENESIS HOUSE I II III & OASIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2011
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19211 ANGLIN ST
DETROIT MI
48234-1460
US

IV. Provider business mailing address

150 STIMSON ST
DETROIT MI
48201-2410
US

V. Phone/Fax

Practice location:
  • Phone: 313-263-0077
  • Fax: 313-831-2299
Mailing address:
  • Phone: 313-263-0077
  • Fax: 313-831-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number820317
License Number StateMI

VIII. Authorized Official

Name: MS. VANESSA COOPER
Title or Position: DIRECTOR, TREATMENT
Credential: MA
Phone: 313-993-4700