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General NPI Number Information
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NPI Number | 1578850251
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Entity Type | Organization
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Legal Business Name | DETROIT RECOVERY PROJECT
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Dates
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Enumeration Date | 07/01/2011
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Last Update Date | 09/26/2013
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Provider Practice Location Address
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Address Line | 1121 EAST MC NICHOLS
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City | DETROIT
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State | MI
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Zip | 48203
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Country | US
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Telephone | 313-365-3113
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Fax | 313-365-3098
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Provider Business Mailing Address
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Address Line | 1121 EAST MC NICHOLS
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City | DETROIT
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State | MI
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Zip | 48203
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Country | US
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Telephone | 313-365-3113
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Fax | 313-365-3098
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. VIRDELL FAUSTINA THOMAS
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Credential | MSW, LMSW
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Telephone | 313-365-3113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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