LIFE CHALLENGE OF SOUTHEASTERN MICHIGAN (NPI# 1205304359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205304359 |
| Entity Type | Organization |
| Organization Name | LIFE CHALLENGE OF SOUTHEASTERN MICHIGAN |
| Practice Address |
17667 Pierson St Detroit MI 48219-2520 |
| Practice Telephone | 3135310111 |
| Mailing Telephone | 3135310111 |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2018-11-07 |
| Authorized Official Name | KEN KEENE (DIRECTOR) |
| Authorized Official Telephone | 3135310111 |
| Authorized Official Credential | MDIV |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
17667 PIERSON ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48219-2520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750855524 | Laura Hall | Social Worker | 17667 Pierson St, Detroit, MI 48219-2520 | 2019-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396008 | Betty Jean Fairchild-el | Home Health Aide | 20018 Norhtrop, Detroit, MI 48219 | 2020-11-04 |
| 1134787633 | Behavioral Health Professionals, Inc | Family Medicine | 19750 Burt Road, Detroit, MI 48219 | 2019-05-31 |
| 1255997755 | Shvaughn Laniece Nunley | Social Worker | 18422 W Mcnichols Rd, Detroit, MI 48219 | 2019-05-10 |
| 1770081168 | D & D Enterprise Group LLC | Durable Medical Equipment & Medical Supplies | 17405 Lahser, 202, Detroit, MI 48219 | 2018-01-31 |
| 1972011369 | Fibers of The Family LLC | Home Health | 16800 Edinborough Rd, Detroit, MI 48219 | 2018-01-19 |
| 1871049684 | Monique Jackson | Occupational Therapist | 21630 Jessel Ave, Detroit, MI 48219 | 2016-08-31 |
| 1114379773 | Audrey Hopkins | Licensed Practical Nurse | 20277 Redfren, Detroit, MI 48219 | 2016-07-07 |
| 1649628785 | Erin Bianco | Social Worker | 17321 Telegraph Rd., Detroit, MI 48219 | 2016-05-31 |
| 1144674664 | Lucinda Galmon-wallace | Technician, Other | 24424 Telegraph Road, Detroit, MI 48219 | 2016-04-21 |
| 1598120925 | Faith's Place LLC | Psychiatric Residential Treatment Facility | 16725 Blackstone Street, Detroit, MI 48219 | 2015-12-30 |
| Find all providers in zip 48219 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386251841 | Diversified Community Services | Counselor | 10301 W 7 Mile Rd, Detroit, MI 48221-1962 | 2020-09-29 |
| 1750907853 | Ronnie Stephen | Counselor | 15025 Fenkell St, Detroit, MI 48227-2647 | 2020-06-24 |
| 1144860552 | Allen Hugh Warrick IIi | Counselor | 9605 Grand River Ave # A, Detroit, MI 48204-2139 | 2020-01-14 |
| 1396309878 | Darnesha Coy | Counselor | 17870 Dresden St, Detroit, MI 48205-3138 | 2019-04-30 |
| 1518438746 | Curron Thomas | Counselor | 16850 Wyoming St, Apartment 328, Detroit, MI 48221-3415 | 2018-12-16 |
| 1861962094 | Reid Talley | Counselor | 12010 Elmhurst, Detroit, MI 48206 | 2018-11-30 |
| 1598233892 | Michigan Employment & Training Plus | Counselor | 6522 Piedmont St, Detroit, MI 48228-4950 | 2018-11-05 |
| 1821588773 | Avery Brown Jr. | Counselor | 8333 Townsend St, Detroit, MI 48213-2331 | 2018-05-16 |
| 1538669304 | Helping Hands Community Centers 1 | Counselor | 2434 Chicago Blvd, Detroit, MI 48206-1741 | 2018-02-17 |
| 1326551094 | Hussian Fry | Counselor | 66 Adelaide St Apt 18, Detroit, MI 48201-3111 | 2017-11-15 |
| 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.