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NPI Code Detail

MEDICARE: DETROIT RESCUE MISSION MINISTRIES

MEDICARE: DETROIT RESCUE MISSION MINISTRIES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13245S0500XChildren's Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number : 1285932459
Entity Type Code : Organization
Provider Name (Legal Business Name) : DETROIT RESCUE MISSION MINISTRIES
Provider Business Mailing Address
First Line : 91 GLENDALE ST
Second Line :
City : HIGHLAND PARK
State : MI
Zip : 48203-3274
Country : US
Telephone Number : 313-263-0077
Fax Number :
Provider Business Practice Location Address
First Line : 91 GLENDALE ST
Second Line :
City : HIGHLAND PARK
State : MI
Zip : 48203-3274
Country : US
Telephone Number : 313-263-0077
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MISS VANESSA COOPER
Credential :
Telephone Number : 313-263-0077
Provider Enumeration Date : 03/11/2011
Last Update Date : 03/11/2011

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Directions to “DETROIT RESCUE MISSION MINISTRIES ” Practice Location

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