MARINERS INN


Address: 445 Ledyard St, Detroit, MI 48201-2641
Phone: 3139629446

MARINERS INN (NPI# 1558485466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320800000X Community Based Residential Treatment Facility, Mental Illness SA820152 MI Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MI TPIN ASSIGNMENT 56421819 01

Other Provider IDs and Locations

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

Other Data Sources

Entity Type Entity Name Entity Address
Massachusetts Corporations MARINERS INN, INC. 53 Oakdale Avenue, Marion, MA 02738

Office Location

Street Address 445 LEDYARD ST
City DETROIT
State MI
Zip Code 48201-2641

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 320800000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment Facility, Mental Illness

Taxonomy Definition

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

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
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Competitor

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City DETROIT
Zip Code 48201

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Dataset Information

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.

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