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General NPI Number Information
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NPI Number | 1053736363
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Entity Type | Organization
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Legal Business Name | EMPOWERMENT ZONE COALITION, INC.
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Dates
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Enumeration Date | 02/24/2014
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 4146 LAKEWOOD ST
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City | DETROIT
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State | MI
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Zip | 48215-2306
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Country | US
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Telephone | 313-921-9403
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Fax | 313-921-9412
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Provider Business Mailing Address
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Address Line | 4146 LAKEWOOD ST
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City | DETROIT
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State | MI
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Zip | 48215-2306
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Country | US
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Telephone | 313-921-9403
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Fax | 313-921-9412
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. DOREEN TURK-WHITE
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Credential | M.ED., CHES, CPC-M
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Telephone | 313-921-9403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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