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General NPI Number Information
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NPI Number | 1518760776
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Entity Type | Organization
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Legal Business Name | MAP CO. LLC
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 18441 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48219-4113
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Country | US
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Telephone | 313-522-9399
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Fax |
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Provider Business Mailing Address
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Address Line | 92 KENILWORTH ST
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City | DETROIT
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State | MI
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Zip | 48202-1620
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Country | US
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Telephone | 313-522-9399
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | PATRICIA KPAN
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Credential |
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Telephone | 313-522-9399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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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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Taxonomy #5
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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