Healthcare Provider Details

I. General information

NPI: 1326263922
Provider Name (Legal Business Name): FRANK EDWARD DENKINS SR. BACHELORS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8656 HERITAGE PL UNIT #105
DETROIT MI
48204-3779
US

IV. Provider business mailing address

8656 HERITAGE PLACE UNIT #105
DETROIT MI
48201
US

V. Phone/Fax

Practice location:
  • Phone: 313-878-2919
  • Fax:
Mailing address:
  • Phone: 313-878-2919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number820152
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: