MARINERS INN (NPI# 1558485466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558485466 |
Entity Type | Organization |
Organization Name | MARINERS INN |
Practice Address |
445 Ledyard St Detroit MI 48201-2641 |
Practice Telephone | 3139629446 |
Practice Fax Number | 3139626395 |
Mailing Telephone | 3139629446 |
Mailing Fax Number | 3139626395 |
Enumeration Date | 2007-03-17 |
Last Update Date | 2018-04-20 |
Authorized Official Name | MR. DAVID SAMPSON (CHIEF EXECUTIVE OFFICER) |
Authorized Official Telephone | 3139629446 |
Authorized Official Credential | LMSW |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | SA820152 | MI | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MI | TPIN ASSIGNMENT | 56421819 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184835084 | Mariners Inn | Substance Abuse Rehabilitation Facility | 14108 Mark Twain St, 445 Ledyard, Detroit, MI 48227-2835 | 2007-05-24 |
Entity Type | Entity Name | Entity Address |
---|---|---|
Massachusetts Corporations | MARINERS INN, INC. | 53 Oakdale Avenue, Marion, MA 02738 |
Street Address |
445 LEDYARD ST |
City | DETROIT |
State | MI |
Zip Code | 48201-2641 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457969198 | Stefanie Alston | Counselor | 445 Ledyard St, Detroit, MI 48201 | 2020-07-20 |
1851919674 | Valencia Ann Frank | Community Health Worker | 445 Ledyard St, Detroit, MI 48201 | 2020-07-08 |
1508484510 | Edward A Gardin | Community Health Worker | 445 Ledyard St, Detroit, MI 48201 | 2020-07-07 |
1609422617 | Ashley Volkman | Specialist | 445 Ledyard St, Detroit, MI 48201-2641 | 2019-08-15 |
1427534536 | Ariel Joy Farley | Social Worker | 445 Ledyard St, Detroit, MI 48201-2641 | 2018-07-12 |
1265946271 | Christina Shamily | Specialist | 445 Ledyard St, Detroit, MI 48201-2641 | 2017-11-29 |
1629582770 | Portia Hardrick-brown | Specialist | 445 Ledyard St, Detroit, MI 48201-2641 | 2017-11-28 |
1760919401 | Larry Dean Gudith | Peer Specialist | 445 Ledyard St, Detroit, MI 48201-2641 | 2017-05-12 |
1922534023 | Dorothy Vukmirovich | Substance Abuse Rehabilitation Facility | 445 Ledyard St, Detroit, MI 48201-2641 | 2017-05-10 |
1609316777 | Payton Jackson IIi | Community/Behavioral Health | 445 Ledyard St, Detroit, MI 48201-2641 | 2017-03-08 |
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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 | 320800000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment Facility, Mental Illness |
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750859229 | The Noble Home II, Inc | Community Based Residential Treatment Facility, Mental Illness | 327 E Grand Blvd, Detroit, MI 48207-3616 | 2018-11-02 |
1679048870 | Neighborhood Living Services,inc. | Community Based Residential Treatment Facility, Mental Illness | 23001 Norfolk St, Detroit, MI 48219-1185 | 2018-10-04 |
1851875371 | People Community of Michigan Afc Homes, Inc. | Community Based Residential Treatment Facility, Mental Illness | 16829 Monica St, Detroit, MI 48221-2969 | 2018-09-20 |
1083169502 | Emmanuel House | Community Based Residential Treatment Facility, Mental Illness | 14750 Saint Marys St, Detroit, MI 48227-1862 | 2016-08-25 |
1407234586 | Karen Frederick LLC | Community Based Residential Treatment Facility, Mental Illness | 5781 Beaconsfield St, Detroit, MI 48224-3157 | 2015-05-11 |
1861882821 | Inclusive Solutions LLC | Community Based Residential Treatment Facility, Mental Illness | 4535 Chrysler Dr, Detroit, MI 48201-1954 | 2015-01-29 |
1306257852 | Victory Unto Salvation Faith Ministries Dba The Philip House Mission | Community Based Residential Treatment Facility, Mental Illness | 18066 James Couzens Fwy, 2305 Pasadena, Detroit, MI 48235-2646 | 2014-05-17 |
1437586039 | Read All About It Literacy Center | Community Based Residential Treatment Facility, Mental Illness | 2727 Second Ave Suite 124, Detroit, MI 48201-4025 | 2013-09-27 |
1184922627 | Shar Inc. | Community Based Residential Treatment Facility, Mental Illness | 1852 W.grand Blvd, Detroit, MI 48208 | 2011-03-08 |
1356648034 | Shining Star Ll | Community Based Residential Treatment Facility, Mental Illness | 533 Mcdougall St, Detroit, MI 48207-3912 | 2011-02-16 |
Find all providers in DETROIT |
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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.