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General NPI Number Information
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NPI Number | 1770488918
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Entity Type | Organization
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Legal Business Name | H.O.D BUSINESS COMMUNITY OUTREACH
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 4000 W BUENA VISTA ST
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City | DETROIT
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State | MI
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Zip | 48238-3204
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Country | US
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Telephone | 313-707-0972
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Fax |
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Provider Business Mailing Address
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Address Line | 2785 E GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48211-2003
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Country | US
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Telephone | 313-707-0972
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | AYESHAH ALBERT
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Credential | M.ED., CHWC
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Telephone | 248-701-5166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State | NULL
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Taxonomy #4
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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 | NULL
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Taxonomy #5
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State | NULL
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Taxonomy #6
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State | NULL
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