Healthcare Provider Details

I. General information

NPI: 1477864361
Provider Name (Legal Business Name): DETERMINED FRIENDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 06/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16118 MANNING ST
DETROIT MI
48205-2078
US

IV. Provider business mailing address

16118 MANNING ST
DETROIT MI
48205-2078
US

V. Phone/Fax

Practice location:
  • Phone: 313-779-0187
  • Fax:
Mailing address:
  • Phone: 313-779-0187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MRS. BRENDA DEMETRISE HOSKINS
Title or Position: PRESIDENT
Credential:
Phone: 313-779-0187