Healthcare Provider Details

I. General information

NPI: 1144303504
Provider Name (Legal Business Name): DUAL INSIGHT NON-PROFIT HOUSING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 ADELAIDE ST
DETROIT MI
48201-3110
US

IV. Provider business mailing address

93 ADELAIDE ST
DETROIT MI
48201-3110
US

V. Phone/Fax

Practice location:
  • Phone: 248-569-6019
  • Fax: 248-569-9175
Mailing address:
  • Phone: 248-569-6019
  • Fax: 248-569-9175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateMI

VIII. Authorized Official

Name: LULA M EUBANKS
Title or Position: ADMINISTRATOR
Credential:
Phone: 313-833-9141