MS. VICKIE MCTAW (NPI# 1669703146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669703146 |
| Entity Type | Individual |
| Full Name | MS. VICKIE MCTAW |
| Credential | CAC-M |
| Practice Address |
2409 Calvert St Detroit MI 48206-1533 |
| Mailing Address |
35390 Van Born Rd Apt 303 Wayne MI 48184-3317 |
| Practice Telephone | 3138696905 |
| Mailing Telephone | 7349347701 |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2010-01-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | $$$$$$$$$ | MI | Residential Treatment Facilities |
| Street Address |
2409 CALVERT ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48206-1533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760716856 | Marquetta Leona Williams | Counselor | 2409 Calvert St, Detroit, MI 48206-1533 | 2009-09-23 |
| 1679803464 | Guiding Light Sober Living | Substance Abuse Rehabilitation Facility | 2409 Calvert St, Detroit, MI 48206-1533 | 2009-12-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861962094 | Reid Talley | Counselor | 12010 Elmhurst, Detroit, MI 48206 | 2018-11-30 |
| 1306330246 | Harper's Care Club, LLC | Home Health | 1732 W Bethune St Apt 4, Detroit, MI 48206 | 2018-06-14 |
| 1700210440 | Tender Loving Care Assisted Living | Custodial Care Facility | 2250 W.euclid, Detroit, MI 48206 | 2013-08-29 |
| 1063560761 | Platinum Care Pharmacy Inc. | Pharmacy | 8500 14th Street, Detroit, MI 48206 | 2007-01-08 |
| 1619067527 | Young-sims Clinic PC | Family Medicine | 9150 Linwood, Detroit, MI 48206 | 2006-10-13 |
| 1093811200 | Grace W Patterson | Family Medicine | 9150 Linwood Ave, Detroit, MI 48206 | 2006-09-15 |
| 1164437992 | Rosa Park Medical Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 8665 Rosa Parks Boulavard, Detroit, MI 48206 | 2006-07-30 |
| 1336495696 | Ephraim I Onwuegbuchu | Pharmacist | 8500 14th Street, Detroit, MI 48206 | 2012-07-24 |
| 1962647552 | Jabez Recovery Management Services, Inc | Substance Abuse Rehabilitation Facility | 2755 Collingwood St, Detroit, MI 48206 | 2008-12-10 |
| 1033215918 | Robert Nmn Sims | Family Medicine | 9150 Linwood Ave, Detroit, MI 48206 | 2006-09-16 |
| Find all providers in zip 48206 | ||||
| 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.