Healthcare Provider Details

I. General information

NPI: 1114520806
Provider Name (Legal Business Name): S.A.Y DETROIT HEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 GLENDALE ST STE 1000
HIGHLAND PARK MI
48203-3231
US

IV. Provider business mailing address

211 GLENDALE ST STE 1000
HIGHLAND PARK MI
48203-3231
US

V. Phone/Fax

Practice location:
  • Phone: 313-758-6100
  • Fax:
Mailing address:
  • Phone: 313-758-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAWANA NETTLES-ROBINSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 313-758-6100