Healthcare Provider Details

I. General information

NPI: 1255410023
Provider Name (Legal Business Name): POSITIVE IMAGES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13340 E WARREN AVE
DETROIT MI
48215-2112
US

IV. Provider business mailing address

13340 E WARREN AVE
DETROIT MI
48215-2112
US

V. Phone/Fax

Practice location:
  • Phone: 313-822-6940
  • Fax: 313-822-6946
Mailing address:
  • Phone: 313-822-6940
  • Fax: 313-822-6946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number822778
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MAISHA KENYATTA
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW
Phone: 313-822-6940