DETROIT COMMUNITY HEALTH CONNECTION, INC (NPI# 1588137376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588137376 |
| Entity Type | Organization |
| Organization Name | DETROIT COMMUNITY HEALTH CONNECTION, INC |
| Practice Address |
20303 Kelly Rd Detroit MI 48225-1206 |
| Mailing Address |
13901 E Jefferson Ave Detroit MI 48215-2720 |
| Practice Telephone | 3133472116 |
| Practice Fax Number | 3132457009 |
| Mailing Telephone | 3138212591 |
| Mailing Fax Number | 3138224202 |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2019-01-04 |
| Authorized Official Name | MAHIPAL RAO KAKARALA (SR VP & CFO) |
| Authorized Official Telephone | 3138212591 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Dr. Peter Slaughter Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851554034 | Detroit Community Health Connection, Inc | Clinic/Center | 111 W 7 Mile Rd, Detroit, MI 48203-1968 | 2008-07-08 |
| 1174906184 | Detroit Community Health Connection, Inc | Clinic/Center | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2015-07-08 |
| 1568737500 | Detroit Community Health Connection, Inc | Clinic/Center | 111 W 7 Mile Rd, Detroit, MI 48203-1968 | 2012-03-08 |
| 1356614721 | Detroit Community Health Connection, Inc | Clinic/Center | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2012-02-16 |
| 1063790186 | Detroit Community Health Connection, Inc | Clinic/Center | 12800 E Warren Ave, Detroit, MI 48215-2061 | 2011-07-22 |
| 1053574236 | Detroit Community Health Connection, Inc | Clinic/Center | 6550 W Warren Ave, Detroit, MI 48210-1134 | 2008-07-08 |
| 1275796468 | Detroit Community Health Connection, Inc | Clinic/Center | 7900 Kercheval St, Detroit, MI 48214-2439 | 2008-07-08 |
| 1790948982 | Detroit Community Health Connection, Inc | Clinic/Center | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2008-07-08 |
| Street Address |
20303 KELLY RD |
| City | DETROIT |
| State | MI |
| Zip Code | 48225-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225296130 | Kathryn Anne Clampitt-voiles | Social Worker | 20303 Kelly Rd, Detroit, MI 48225-1206 | 2008-05-28 |
| 1699391912 | Juliet Hope Gustafson | Social Worker | 20303 Kelly Rd, Detroit, MI 48225-1206 | 2020-06-23 |
| 1760006910 | Hailie Hogan-wilson | Student in an Organized Health Care Education/Training Program | 20303 Kelly Rd, Detroit, MI 48225-1206 | 2020-06-03 |
| 1679104301 | Stacy Jean-baptiste | Social Worker | 20303 Kelly Rd, Detroit, MI 48225-1206 | 2020-01-31 |
| 1710525241 | Jason Williams | Peer Specialist | 20303 Kelly Rd, Detroit, MI 48225-1206 | 2019-12-16 |
| 1194377507 | Dorothy Jean Yarrington | Social Worker | 20303 Kelly Rd, Detroit, MI 48225-1206 | 2019-07-15 |
| 1821598160 | Arielle Rochell Wilson | Social Worker | 20303 Kelly Rd, Detroit, MI 48225-1206 | 2018-02-13 |
| 1780182436 | Lakeidra Bronner | Social Worker | 20303 Kelly Rd, Detroit, MI 48225-1206 | 2018-01-29 |
| 1366976722 | Delisa Glaspie | Community/Behavioral Health | 20303 Kelly Rd, Detroit, MI 48225-1206 | 2017-04-12 |
| 1972041622 | Savannah Rose Moffat | Social Worker | 20303 Kelly Rd, Detroit, MI 48225-1206 | 2017-02-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639660046 | Ingrid Lewis | Registered Nurse | 20831 Ridgemont Rd, Harper Woods, MI 48225 | 2018-05-21 |
| 1699264598 | Jeffrey Brooks | Licensed Practical Nurse | 20415 Balfour St, Apt 4, Harper Woods, MI 48225 | 2018-05-07 |
| 1518373430 | Meah Khrysteana Tweh | Technician, Other | 20995 Bournemouth, Harper Woods, MI 48225 | 2014-07-11 |
| 1376878256 | Thomas Thurman | Social Worker | 20303 Kelly Rd., Detroit, MI 48225 | 2009-10-09 |
| 1376799320 | Ronald Brian Cornish | Massage Therapist | 20010 Kelly Rd, Harperwoods, MI 48225 | 2008-08-11 |
| 1811167562 | Family First Home Care LLC | Home Health | 19959 Vernier, Suite 1a, Harper Woods, MI 48225 | 2008-03-10 |
| 1922185982 | Odette Roye Haouilou | Dentist | 18000 Vernier, Harper Woods, MI 48225 | 2006-11-01 |
| 1831286236 | Gerald Joseph Fedon | Dentist | 20840 Vernier Rd, Harper Woods, MI 48225 | 2006-10-06 |
| 1790213759 | Horacio Enrique Falcon | Dentist | 20690 Vernier Rd, Harper Woods, MI 48225 | 2017-06-02 |
| 1609058585 | Patricia Ann Peet | Durable Medical Equipment & Medical Supplies | 19566 Kelly Rd, Harper Woods, MI 48225 | 2007-12-03 |
| Find all providers in zip 48225 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679195721 | Family Medical Center of Michigan,inc | Clinic/Center | 2740 Collingwood St Ste 100, Detroit, MI 48206-1473 | 2020-05-12 |
| 1154892958 | Family Medical Center of Michigan, Inc | Clinic/Center | 2425 Tuxedo St Rm 115, Detroit, MI 48206-1222 | 2018-12-06 |
| 1801361464 | Detroit Health Care for The Homeless | Clinic/Center | 1355 Oakman Blvd, Detroit, MI 48238-2849 | 2018-10-10 |
| 1306329800 | Family Medical Center of Michigan,inc | Clinic/Center | 15531 Linwood St Rm 102, Detroit, MI 48238-1465 | 2018-09-11 |
| 1982072963 | Detroit Healthcare for The Homeless | Clinic/Center | 1234 Porter St, Detroit, MI 48226-2407 | 2015-09-09 |
| 1851554034 | Detroit Community Health Connection, Inc | Clinic/Center | 111 W 7 Mile Rd, Detroit, MI 48203-1968 | 2008-07-08 |
| 1396839981 | Detroit Health Care for The Homeless | Clinic/Center | 60 E. Warren, Detroit, MI 48201 | 2006-10-03 |
| 1285735845 | Detroit Health Care for The Homeless | Clinic/Center | 20548 Fenkell, Detroit, MI 48223 | 2006-09-26 |
| 1275576886 | Ronaldo B Supena | Clinic/Center | 611 Martin Luther King Jr Blvd, Detroit, MI 48201-2273 | 2006-06-13 |
| 1033109244 | Community Health and Social Services Center, Inc | Clinic/Center | 7436 Woodward Ave, Detroit, MI 48202-3100 | 2005-10-27 |
| 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.