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General NPI Number Information
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NPI Number | 1437386976
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Entity Type | Organization
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Legal Business Name | DOUSE HOUSE
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Dates
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Enumeration Date | 06/11/2009
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Last Update Date | 06/11/2009
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Provider Practice Location Address
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Address Line | 14615 METTETAL ST
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City | DETROIT
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State | MI
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Zip | 48227-1877
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Country | US
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Telephone | 313-523-3324
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Fax |
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Provider Business Mailing Address
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Address Line | 14615 METTETAL
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City | DETROIT
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State | MI
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Zip | 48224
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Country | US
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Telephone | 313-523-3324
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. MIWAR DOUSE
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Credential |
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Telephone | 313-523-3324
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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