NPI 1790373579

Central Care Management Organization

Organisation Prevention Professional Detroit, MI

Practice location

Address: 3031 W Grand Blvd STE 370, Detroit, MI 48202-3008
Phone: (313) 875-2092
Fax: (313) 875-2092

Authorised official

Name: Reginald Charles Terry
Title: Prevention Director
Phone: (313) 875-2092

Registered specialties (2)

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X

Other Prevention Professional providers in Michigan →

Case Management Agency

Agencies Taxonomy 251B00000X

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Registry record

NPI: 1790373579
Entity type: Organization
NPI issued: 6 Jan 2021
Record last updated: 6 Jan 2021

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.