DETROIT CENTRAL CITY COMMUNITY MENTAL HEALTH, INC. (NPI# 1861813685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861813685 |
| Entity Type | Organization |
| Organization Name | DETROIT CENTRAL CITY COMMUNITY MENTAL HEALTH, INC. |
| Other Organization Name | CENTRAL CITY INTEGRATED HEALTH |
| Practice Address |
17950 Woodward Ave Detroit MI 48203-2260 |
| Practice Telephone | 3138313160 |
| Practice Fax Number | 3138260567 |
| Mailing Telephone | 3138317100 |
| Mailing Fax Number | 3138260567 |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | RYAN LEPPER (CEO) |
| Authorized Official Telephone | 3137331322 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
MI | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Central City Integrated Health | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10 Peterboro St, Detroit, MI 482012722 | 3135786123 | |
| 3427 Woodward Ave, Detroit, MI 482012725 | 3138313160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730535808 | Detroit Central City Community Mental Health, Inc. | Clinic/Center | 3427 Woodward Ave, Detroit, MI 48201-2722 | 2016-05-09 |
| Street Address |
17950 WOODWARD AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48203-2260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669479564 | Total Care Physical Therapy & Rehabilitation, Inc | Clinic/Center | 17950 Woodward Ave, 2nd Floor, Detroit, MI 48203-2260 | 2005-07-07 |
| 1093201790 | Lowantha Calloway | Peer Specialist | 17950 Woodward Ave, Detroit, MI 48203-2260 | 2018-07-05 |
| 1679823389 | Healthcare Administrative Services LLC | General Practice | 17950 Woodward Ave, Upper Level, Detroit, MI 48203-2260 | 2012-09-11 |
| 1083842256 | Manjula Roy | Family Medicine | 17950 Woodward Ave, Detroit, MI 48203-2260 | 2009-06-26 |
| 1487731816 | Maimoona Hakim Husain | General Practice | 17950 Woodward Ave, Detroit, MI 48203-2260 | 2006-11-01 |
| 1730275868 | St. Joseph Medical Center PC | Family Medicine | 17950 Woodward Ave, Detroit, MI 48203-2260 | 2006-10-05 |
| 1053351908 | Franklin Medical Pharmacy Inc | Pharmacy | 17950 Woodward Ave, Detroit, MI 48203-2260 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992355135 | James Calloway | Peer Specialist | 1211 E Mcnichols, Detroit, MI 48203 | 2019-09-19 |
| 1851868582 | Community Veterans Services Inc | Counselor | 163 Tennyson, Highland Park, MI 48203 | 2018-10-31 |
| 1346601838 | Rainbow Center of Michigan | Health Maintenance Organization | 12501 Hamilton Ave., Highland Park, MI 48203 | 2016-03-11 |
| 1134502354 | Minds Moving In New Directions Inc | Community/Behavioral Health | 62 Massachusetts St, Highland Park, MI 48203 | 2015-07-07 |
| 1811312937 | Brea Holloway | Home Health | 20249 Yacama Rd, Detroit, MI 48203 | 2014-02-26 |
| 1770821795 | St John Providence Health Systems | Community/Behavioral Health | 1150 Lantz St, Detroit, MI 48203 | 2013-01-25 |
| 1871845412 | Waneta Darcell Dickerson | Social Worker | 169 W. Buena Vista, Highlandpark, MI 48203 | 2012-10-05 |
| 1629331939 | Maureen Connolly | Pediatrics | 77 Victor St, Highland Park, MI 48203 | 2012-06-21 |
| 1578850251 | Detroit Recovery Project | Community/Behavioral Health | 1121 East Mc Nichols, Detroit, MI 48203 | 2011-07-01 |
| 1265728414 | Barbara Suzanne Tyson | Home Health | 301 Glendale St, Apt B8, Highland Park, MI 48203 | 2011-06-27 |
| Find all providers in zip 48203 | ||||
| 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.