DETROIT COMMUNITY HEALTH CONNECTION, INC. (NPI# 1215200399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215200399 |
| Entity Type | Organization |
| Organization Name | DETROIT COMMUNITY HEALTH CONNECTION, INC. |
| Other Organization Name | DAAA/DETROIT COMMUNITY HEALTH CONNECTION, INC. |
| Practice Address |
611 Martin Luther King Jr Blvd Detroit MI 48201-2273 |
| Mailing Address |
13901 E Jefferson Ave Detroit MI 48215-2720 |
| Practice Telephone | 3138326300 |
| Practice Fax Number | 3138322075 |
| Mailing Telephone | 3138212591 |
| Mailing Fax Number | 3138224202 |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2012-02-23 |
| Authorized Official Name | MR. MAHIPAL RAO KAKARALA (SRVP/CFO) |
| Authorized Official Telephone | 3138212591 |
| Is Organization Subpart | Y |
| Parent Organization Name | DETROIT COMMUNITY HEALTH CONNECTION, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| DAAA/DETROIT COMMUNITY HEALTH CONNECTION, INC. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124393160 | Detroit Community Health Connection, Inc. | Clinic/Center | 12800 E Warren Ave, Detroit, MI 48215-2061 | 2012-03-08 |
| 1659644722 | Detroit Community Health Connection, Inc. | Clinic/Center | 6550 W Warren Ave, Detroit, MI 48210-1134 | 2012-02-20 |
| 1457624652 | Detroit Community Health Connection, Inc. | Clinic/Center | 7900 Kercheval St, Detroit, MI 48214-2439 | 2012-02-17 |
| 1982611562 | Detroit Community Health Connection, Inc. | Clinic/Center | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2006-08-03 |
| Street Address |
611 MARTIN LUTHER KING JR BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275576886 | Ronaldo B Supena | Clinic/Center | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2006-06-13 |
| 1750732830 | Detroit Community Health Connection | Community/Behavioral Health | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2016-06-29 |
| 1588905830 | Gwen Lee | Registered Nurse | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2013-03-12 |
| 1295073773 | Lavetta Annette Pickens | Nurse Practitioner | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2013-01-18 |
| 1841445640 | Norris Carnell Polk | Pediatrics | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2008-11-20 |
| 1851547038 | Marie Shoulders-williams | Nurse Practitioner | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2008-08-07 |
| 1790948982 | Detroit Community Health Connection, Inc | Clinic/Center | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2008-07-08 |
| 1427084128 | Mayra Troya-nutt | Obstetrics & Gynecology | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2006-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909558 | Quilted Rose Clinical Services, Pllc | Clinic/Center | 269 Walker St Ste 256, Detroit, MI 48207-4258 | 2020-10-15 |
| 1851920581 | Emotional Wellness Group LLC | Clinic/Center | 11956 E Outer Dr, Detroit, MI 48224-2630 | 2020-04-04 |
| 1245897503 | Healthy Choice Community Centered Counseling LLC | Clinic/Center | 19300 Greenfield Rd Ste B, Detroit, MI 48235-2003 | 2019-05-22 |
| 1891245775 | Platinum Psychological Services | Clinic/Center | 4777 E Outer Dr Ste 1154, Detroit, MI 48234-3241 | 2016-10-04 |
| 1750837324 | A Plus Care Transportation LLC | Clinic/Center | 14586 Wisconsin, Detroit, MI 48238 | 2016-09-01 |
| 1093157802 | Medical Massage Clinic of Mi., LLC | Clinic/Center | 17151 Wyoming St, Detroit, MI 48221-2451 | 2013-07-22 |
| 1033461728 | Caring Hands Medical Clinical, P.C. | Clinic/Center | 14219 W. Mc Nichols Road, Detroit, MI 48235 | 2012-10-05 |
| 1558619510 | St John Providence Eastwood Clinic | Clinic/Center | 4777 E Outer Dr Ste 1105, Detroit, MI 48234-3241 | 2012-08-23 |
| 1497997068 | Med Care Clinic LLC | Clinic/Center | 16315 Grand River Ave, Detroit, MI 48227-1825 | 2009-03-29 |
| 1841448446 | Theramatrix, Inc. | Clinic/Center | 18601 Mack Avenue #3, Detroit, MI 48236-3250 | 2008-09-08 |
| Find all providers in DETROIT | ||||
Please comment or provide details below to improve the information on DETROIT COMMUNITY HEALTH CONNECTION, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.