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General NPI Number Information
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NPI Number | 1467862409
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Entity Type | Organization
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Legal Business Name | INSIGHT AND INTERVENTION
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 12071 ROBSON ST
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City | DETROIT
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State | MI
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Zip | 48227-2437
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Country | US
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Telephone | 313-595-6725
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Fax | 313-397-3458
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Provider Business Mailing Address
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Address Line | 12071 ROBSON ST
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City | DETROIT
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State | MI
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Zip | 48227-2437
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Country | US
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Telephone | 313-595-6725
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Fax | 313-397-3458
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Authorized Official
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Title or Position | CEO
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Name | MS. SHERRY EILEEN BROWN
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Credential | LMSW
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Telephone | 313-595-6725
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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 | 6801085593
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 680185593
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License Number State | MI
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Taxonomy #3
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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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