DETROIT VAMC (NPI# 1154781615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154781615 |
| Entity Type | Organization |
| Organization Name | DETROIT VAMC |
| Other Organization Name | DETROIT VA CARE SITE |
| Practice Address |
4777 E Outer Dr Detroit MI 48234-3241 |
| Mailing Address |
Po Box 5426 Madison WI 53705-0426 |
| Practice Telephone | 6088217200 |
| Mailing Telephone | 6088217200 |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2017-03-01 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| DETROIT VA CARE SITE | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497143374 | Detroit Vamc | Clinic/Center | 301 Piquette Street, Detroit, MI 48202-3513 | 2014-12-31 |
| 1922048750 | Detroit Vamc | Clinic/Center | 7470 Brockway Rd, Brockway, MI 48097-3458 | 2006-06-08 |
| 1609815034 | Detroit Vamc | Clinic/Center | 44200 Woodward Ave, Suite 208, Pontiac, MI 48341-5045 | 2006-06-04 |
| 1366491136 | Detroit Vamc | General Acute Care Hospital | 4646 John R St, Detroit, MI 48201-1916 | 2006-05-09 |
| 1184682007 | Detroit Vamc | Department of Veterans Affairs (VA) Pharmacy | 4646 John R St, Detroit, MI 48201-1916 | 2006-05-02 |
| Street Address |
4777 E OUTER DR |
| City | DETROIT |
| State | MI |
| Zip Code | 48234-3241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841230745 | Carla M Smith | Social Worker | 4777 E Outer Dr, Ste 183, Detroit, MI 48234-3241 | 2006-06-08 |
| 1962018457 | A Baby's Life, LLC | Case Management | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2020-09-20 |
| 1154933265 | Healing House, LLC | Community/Behavioral Health | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2020-08-19 |
| 1063063295 | Allison Jay | Dietitian, Registered | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2019-09-29 |
| 1063069359 | Faster Care Connor Creek, Pllc | Internal Medicine | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2019-08-21 |
| 1699335562 | Sidney Sharee-celestine Sparks | Social Worker | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2019-06-13 |
| 1417420514 | Alyssia Chantel Hence | Social Worker | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2019-01-10 |
| 1164917639 | Conner Creek Life Solutions LLC | Substance Abuse Rehabilitation Facility | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2018-06-27 |
| 1790292928 | Golden Point Community LLC | Assisted Living Facility | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2018-01-09 |
| 1154850543 | Stephanie Graves | Social Worker | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2017-06-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205332483 | Bryce Xavier Bredell | Student in an Organized Health Care Education/Training Program | 6071 E Outer Dr, Detroit, MI 48234 | 2018-04-05 |
| 1538668595 | Constance Durden | Social Worker | 19940 Conant Suite B, Detroit, MI 48234 | 2018-02-06 |
| 1891217717 | Donald Williams | Case Manager/Care Coordinator | 19133 Hasse, Detroit, MI 48234 | 2017-07-12 |
| 1063865830 | Gloria A. Love | Psychologist | 19677 Revere, Detroit, MI 48234 | 2016-07-18 |
| 1972977429 | Conant Garden Dental Center Dds PC | Dentist | 2430 E Seven Mile, Suite 6, Detroit, MI 48234 | 2015-11-20 |
| 1861878787 | Kenyatta Philips | Chore Provider | 20119 Helen St, Detroit, MI - MICHIGAN 48234 | 2015-08-03 |
| 1083977144 | Edward Powell | Counselor | 19436 Packard Street, Detroit, MI 48234 | 2012-06-22 |
| 1487931325 | Sonia Renee George | Case Manager/Care Coordinator | 8331 Yolanda St., Detroit, MI 48234 | 2011-11-07 |
| 1851682215 | Detroit Rescue Mission Ministries | Substance Abuse Rehabilitation Facility | 19211 Anglin, Detroit, MI 48234 | 2011-04-20 |
| 1558662742 | Tenille Daniel | Home Health | 17210 Runyon, Detroit, MI 48234 | 2010-11-04 |
| Find all providers in zip 48234 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598120925 | Faith's Place LLC | Psychiatric Residential Treatment Facility | 16725 Blackstone Street, Detroit, MI 48219 | 2015-12-30 |
| 1164753828 | Is-care Cls, Inc. | Psychiatric Residential Treatment Facility | 1777 N Rademacher St, Detroit, MI 48209-2049 | 2010-01-20 |
| 1356511372 | Detroit Behavioral Institute, LLC | Psychiatric Residential Treatment Facility | 3500 John R St, Detroit, MI 48201-2402 | 2008-03-05 |
| 1265602288 | Carole Elyse Dix | Psychiatric Residential Treatment Facility | 4646 John R St, Detroit, MI 48201-1916 | 2008-03-05 |
| 1386832491 | Tgw Medical Inc | Psychiatric Residential Treatment Facility | 8537 Van Dyke St, Detroit, MI 48213-2374 | 2007-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164837431 | Common Ground | Psychiatric Residential Treatment Facility | 1200 Telegraph Rd, Pontiac, MI 48341 | 2014-06-25 |
| 1104249374 | Common Ground | Psychiatric Residential Treatment Facility | 1410 Telegraph Road, Pontiac, MI 48332 | 2014-01-24 |
| 1881961498 | The Meadows Specialized Residential Program | Psychiatric Residential Treatment Facility | 55377 Walterspaugh Rd, Mendon, MI 49072-9545 | 2011-11-27 |
| 1518129295 | Advance Care Incorporated | Psychiatric Residential Treatment Facility | 34932 Ecorse Rd, Romulus, MI 48174-1642 | 2008-06-25 |
| 1245375823 | D & M Consultants, Inc | Psychiatric Residential Treatment Facility | 25071 West Ten Mile Road, Southfield, MI 48033 | 2007-02-21 |
| 1578582672 | Ccs/lansing, Inc | Psychiatric Residential Treatment Facility | 101 W Townsend Rd, Saint Johns, MI 48879-9200 | 2006-07-19 |
| 1710351598 | Eagle Village | Psychiatric Residential Treatment Facility | 4507 170th Ave, Hersey, MI 49639-8785 | 2015-11-17 |
| 1407228091 | Cynthia Lajoice Ford | Psychiatric Residential Treatment Facility | 1110 Eldon Baker Dr, Flint, MI 48507-1923 | 2015-10-22 |
| 1871831750 | Wolverine Human Services | Psychiatric Residential Treatment Facility | 150 Enterprise Dr, Vassar, MI 48768-9584 | 2013-01-28 |
| 1295082188 | Hope Network Genesee Regional Cru | Psychiatric Residential Treatment Facility | 70 Lafayette St, Pontiac, MI 48342-2033 | 2012-08-09 |
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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.