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General NPI Number Information
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NPI Number | 1285932459
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Entity Type | Organization
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Legal Business Name | DETROIT RESCUE MISSION MINISTRIES
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 91 GLENDALE ST
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City | HIGHLAND PARK
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State | MI
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Zip | 48203-3274
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Country | US
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Telephone | 313-263-0077
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Fax |
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Provider Business Mailing Address
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Address Line | 91 GLENDALE ST
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City | HIGHLAND PARK
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State | MI
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Zip | 48203-3274
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Country | US
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Telephone | 313-263-0077
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MISS VANESSA COOPER
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Credential |
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Telephone | 313-263-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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