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General NPI Number Information
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NPI Number | 1871881268
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Entity Type | Organization
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Legal Business Name | BROADENS HELPING HANDS
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Dates
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Enumeration Date | 07/19/2011
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Last Update Date | 07/19/2011
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Provider Practice Location Address
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Address Line | 2236 HUBBELL ST
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City | DEARBORN
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State | MI
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Zip | 48128-1395
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Country | US
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Telephone | 313-421-9901
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Fax | 313-383-3689
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Provider Business Mailing Address
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Address Line | PO BOX 66
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-0066
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Country | US
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Telephone | 313-421-9901
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Fax | 313-383-3689
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DEIDRA JOYCE BROADEN
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Credential |
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Telephone | 313-421-9901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State | MI
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