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General NPI Number Information
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NPI Number | 1467743245
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Entity Type | Organization
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Legal Business Name | ABAYOMI COMMUNITY DEVELOPMENT CORPORATION
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Dates
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Enumeration Date | 04/27/2011
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Last Update Date | 04/27/2011
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Provider Practice Location Address
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Address Line | 24331 W 8 MILE RD
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City | DETROIT
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State | MI
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Zip | 48219-1028
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Country | US
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Telephone | 313-541-9828
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Fax | 313-541-3820
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Provider Business Mailing Address
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Address Line | 24331 W 8 MILE RD
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City | DETROIT
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State | MI
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Zip | 48219-1028
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Country | US
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Telephone | 313-541-9828
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Fax | 313-541-3820
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Authorized Official
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Title or Position | CEO
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Name | MRS. TAWNYA L MORRIS
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Credential | MHSA
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Telephone | 313-541-9828
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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 | 823071
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 823071
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License Number State | MI
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