Healthcare Provider Details
I. General information
NPI: 1912886177
Provider Name (Legal Business Name): DETROIT INTEGRATED CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/30/2025
Last Update Date: 09/01/2025
Certification Date: 09/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2940 CROOKS RD
ROYAL OAK MI
48073-3278
US
IV. Provider business mailing address
2940 CROOKS RD
ROYAL OAK MI
48073-3278
US
V. Phone/Fax
- Phone: 313-284-2858
- Fax:
- Phone: 313-284-2858
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALEXIS
SKURAS
Title or Position: OWNER
Credential: DNP, APRN, AGCNS-BC
Phone: 586-556-7670