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General NPI Number Information
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NPI Number | 1417241423
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Entity Type | Organization
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Legal Business Name | MECCA STAFFING SOLUTIONS MIHP LLC
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 08/23/2011
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Provider Practice Location Address
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Address Line | 15200 E JEFFERSON SUITE 101 C
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City | GROSSE POINTE PARK
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State | MI
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Zip | 48230-1033
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Country | US
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Telephone | 313-978-3923
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Fax | 313-458-7592
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Provider Business Mailing Address
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Address Line | 15200 E JEFFERSON AVE
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City | GROSSE POINTE PARK
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State | MI
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Zip | 48230-1304
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Country | US
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Telephone | 313-978-3923
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Fax | 313-458-7592
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | AYANNA Z HUTSON
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Credential |
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Telephone | 313-978-3923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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