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General NPI Number Information
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NPI Number | 1598934416
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Entity Type | Organization
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Legal Business Name | THE DETROIT RECOVERY PROJECT, INC
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 1151 TAYLOR ST SUITE 417
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City | DETROIT
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State | MI
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Zip | 48202-1732
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Country | US
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Telephone | 313-876-0770
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Fax | 313-876-0913
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Provider Business Mailing Address
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Address Line | 1151 TAYLOR ST SUITE 417
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City | DETROIT
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State | MI
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Zip | 48202-1732
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Country | US
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Telephone | 313-876-0770
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Fax | 313-876-0913
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. ANDRE JOHNSON
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Credential | MA
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Telephone | 313-876-0770
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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 | 822974
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License Number State | MI
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