Healthcare Provider Details

I. General information

NPI: 1104706175
Provider Name (Legal Business Name): DETROIT INTEGRATED CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29532 SOUTHFIELD RD STE 115
SOUTHFIELD MI
48076-2023
US

IV. Provider business mailing address

2940 CROOKS RD
ROYAL OAK MI
48073-3278
US

V. Phone/Fax

Practice location:
  • Phone: 313-284-2858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEXIS SKURAS
Title or Position: DIRECTOR
Credential: DNP, APRN, AGCNS-BC
Phone: 586-556-7670