NPI 1134341092

Ncadd-Impact Adolescent Health Center

Organisation Substance Abuse Rehabilitation Facility Detroit, MI

Practice location

Address: 5555 Conner St 2000 North, Detroit, MI 48213-3448
Phone: (313) 921-8102
Fax: (313) 921-4184
Mailing address: 488 Frazier St, River Rouge, MI 48218-1025

Authorised official

Name: Laverne Denise McGlothian
Title: Office Manager
Phone: (313) 921-8102

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence C1820235935 (MI)

Other Substance Abuse Rehabilitation Facility providers in Michigan →

Registry record

NPI: 1134341092
Entity type: Organization
NPI issued: 2 May 2007
Record last updated: 14 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.