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NPI Code Detail

MEDICARE: DETROIT EAST COMMUNITY MENTAL HEALTH, INC.

MEDICARE: DETROIT EAST COMMUNITY MENTAL HEALTH, INC.
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
1251S00000XCommunity/Behavioral Health Agency6801001987MI

General Provider Information

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

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Directions to “DETROIT EAST COMMUNITY MENTAL HEALTH, INC. ” Practice Location

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