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General NPI Number Information
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NPI Number | 1477375475
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Entity Type | Organization
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Legal Business Name | FOUNDATIONS DETROIT,LLC
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 3645 E JOLLY RD
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City | LANSING
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State | MI
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Zip | 48910-5774
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Country | US
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Telephone | 517-512-7430
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Fax |
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Provider Business Mailing Address
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Address Line | 3645 E JOLLY RD
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City | LANSING
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State | MI
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Zip | 48910-5774
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Country | US
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Telephone | 517-512-7430
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | STEVE FILTON
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Credential |
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Telephone | 610-768-3482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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