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General NPI Number Information
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NPI Number | 1700904828
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Entity Type | Organization
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Legal Business Name | DETROIT EAST COMMUNITY MENTAL HEALTH, INC.
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 3646 MOUNT ELLIOTT ST
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City | DETROIT
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State | MI
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Zip | 48207-2311
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Country | US
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Telephone | 313-392-0387
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Fax |
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Provider Business Mailing Address
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Address Line | 3646 MOUNT ELLIOTT ST
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City | DETROIT
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State | MI
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Zip | 48207-2311
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Country | US
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Telephone | 313-392-0387
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Fax |
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Authorized Official
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Title or Position | PROGRAM SUPERVISOR
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Name | MRS. DORIS EVELYN STERRETT
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Credential | LMSW, CAC II
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Telephone | 313-921-4700
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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 | 6801001987
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License Number State | MI
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