Healthcare Provider Details

I. General information

NPI: 1871428243
Provider Name (Legal Business Name): DETROIT RESCUE MISSION MINISTRIES GENESIS HOUSE I II III & OASIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 GLENDALE ST
HIGHLAND PARK MI
48203-3231
US

IV. Provider business mailing address

150 STIMSON ST
DETROIT MI
48201-2410
US

V. Phone/Fax

Practice location:
  • Phone: 313-263-0077
  • Fax: 313-831-2299
Mailing address:
  • Phone: 313-263-0077
  • Fax: 313-831-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHAKA CHIPAWE
Title or Position: OWNER
Credential: NP
Phone: 269-277-0952