Healthcare Provider Details

I. General information

NPI: 1003106253
Provider Name (Legal Business Name): ARAB AMERICAN AND CHALDEAN COUNCIL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 09/02/2021
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34628 DEQUINDRE RD
STERLING HEIGHTS MI
48310-5233
US

IV. Provider business mailing address

62 W 7 MILE RD
DETROIT MI
48203-1967
US

V. Phone/Fax

Practice location:
  • Phone: 586-939-5016
  • Fax: 586-593-5194
Mailing address:
  • Phone: 313-893-6172
  • Fax: 313-893-0064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. CARMEN SARAFA
Title or Position: DIRECTOR
Credential: MA, LPC
Phone: 313-893-6172