Healthcare Provider Details

I. General information

NPI: 1295649556
Provider Name (Legal Business Name): LEIGH MINUNE JAMES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3734 MCKINLEY ST
DETROIT MI
48208-2349
US

IV. Provider business mailing address

3734 MCKINLEY ST
DETROIT MI
48208-2349
US

V. Phone/Fax

Practice location:
  • Phone: 313-525-8257
  • Fax: 313-447-2274
Mailing address:
  • Phone: 313-525-8257
  • Fax: 313-447-2274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberAS820419715
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: