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General NPI Number Information
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NPI Number | 1700756137
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Entity Type | Individual
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Provider Name | DESHAWN GROVES
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Gender | Male
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Dates
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Enumeration Date | 11/10/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 882 OAKMAN BLVD
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City | DETROIT
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State | MI
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Zip | 48238-3710
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Country | US
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Telephone | 888-360-9355
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Fax | 888-360-9355
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Provider Business Mailing Address
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Address Line | 42405 NORTHVILLE PLACE DR APT 119
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City | NORTHVILLE
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State | MI
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Zip | 48167-3185
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Country | US
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Telephone | 269-873-3233
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | G612139019364
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License Number State | MI
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