DETROIT COMMUNITY HEALTH CONNECTION, INC (NPI# 1356614721) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356614721 |
| Entity Type | Organization |
| Organization Name | DETROIT COMMUNITY HEALTH CONNECTION, INC |
| Other Organization Name | DAAA/DETROIT COMMUNITY HEALTH CONNECTION, INC. |
| Practice Address |
13901 E Jefferson Ave Detroit MI 48215-2720 |
| Practice Telephone | 3138212591 |
| Practice Fax Number | 3138224202 |
| Mailing Telephone | 3138212591 |
| Mailing Fax Number | 3138224202 |
| Enumeration Date | 2012-02-16 |
| Last Update Date | 2012-02-23 |
| Authorized Official Name | MR. MAHIPAL RAO KAKARAL (SRVP/CFO) |
| Authorized Official Telephone | 3138212591 |
| Is Organization Subpart | Y |
| Parent Organization Name | DETROIT COMMUNITY HEALTH CONNECTION,INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | CERTIFICATE OF ACCREDITATION | 202208 | 01 |
| Other Name | Type Code |
|---|---|
| DAAA/DETROIT COMMUNITY HEALTH CONNECTION, INC. | 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 |
| 1588137376 | Detroit Community Health Connection, Inc | Clinic/Center | 20303 Kelly Rd, Detroit, MI 48225-1206 | 2019-01-04 |
| 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 |
| 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 |
13901 E JEFFERSON AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48215-2720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104856897 | Ann R Gillett-elrington | Obstetrics & Gynecology | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2006-07-05 |
| 1053949701 | Jeffrey Gary Beach | Dietitian, Registered | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2020-03-30 |
| 1598327470 | Tamika Rochelle Hawkins | Nurse Practitioner | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2019-07-01 |
| 1861930448 | Shermanstine Morrow | Licensed Practical Nurse | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2017-02-03 |
| 1174906184 | Detroit Community Health Connection, Inc | Clinic/Center | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2015-07-08 |
| 1376977157 | Sarah Brown-sapp | Registered Nurse | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2013-08-28 |
| 1285971655 | Eucheria Mbata | Nurse Practitioner | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2013-01-05 |
| 1043563448 | Joyce Y. Brown | Registered Nurse | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2012-10-23 |
| 1780936153 | Angelic Marie Douglas | Registered Nurse | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2012-10-10 |
| 1609123348 | Grace Allen Gullett | Registered Nurse | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2012-08-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073035473 | Creative Empowerment Counseling Services, LLC | Community/Behavioral Health | 214 Manistique, Detroit, MI 48215 | 2017-07-07 |
| 1801323530 | Tanya Wade | Social Worker | 12800 E Warren, Detroit, MI 48215 | 2017-05-12 |
| 1992164289 | Juanita Johnson | Counselor | 13336-40 E. Warren Ave, Detroit, MI 48215 | 2016-02-16 |
| 1629476379 | Northeast Guidance Center | Community/Behavioral Health | 12800 Warren, Detroit, MI 48215 | 2014-12-11 |
| 1407253412 | Conner Pharmacy LLC | Pharmacy | 4673 Conner Street, Detroit, MI 48215 | 2014-11-20 |
| 1053734285 | Dawne Robinson | Counselor | 2995 Conner St, Detroit, MI 48215 | 2014-01-23 |
| 1790065357 | Michelle Miller | Counselor | 2900 Conner, Bldg. A, Detroit, MI 48215 | 2011-08-26 |
| 1710286836 | Northeast Guidance Center | Community/Behavioral Health | 2900 Conner St, Ste A, Detroit, MI 48215 | 2011-03-16 |
| 1871892992 | Lisa Nicole Marszalec | Counselor | 12800 East Warren Ave, Detroit, MI 48215 | 2011-03-16 |
| 1881845014 | Deborah A Caldwell | Nutritionist | 13340 E Warren, Detroit, MI 48215 | 2008-10-07 |
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| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952909558 | Quilted Rose Clinical Services, Pllc | Clinic/Center | 269 Walker St Ste 256, Detroit, MI 48207-4258 | 2020-10-15 |
| 1851920581 | Emotional Wellness Group LLC | Clinic/Center | 11956 E Outer Dr, Detroit, MI 48224-2630 | 2020-04-04 |
| 1245897503 | Healthy Choice Community Centered Counseling LLC | Clinic/Center | 19300 Greenfield Rd Ste B, Detroit, MI 48235-2003 | 2019-05-22 |
| 1891245775 | Platinum Psychological Services | Clinic/Center | 4777 E Outer Dr Ste 1154, Detroit, MI 48234-3241 | 2016-10-04 |
| 1750837324 | A Plus Care Transportation LLC | Clinic/Center | 14586 Wisconsin, Detroit, MI 48238 | 2016-09-01 |
| 1093157802 | Medical Massage Clinic of Mi., LLC | Clinic/Center | 17151 Wyoming St, Detroit, MI 48221-2451 | 2013-07-22 |
| 1033461728 | Caring Hands Medical Clinical, P.C. | Clinic/Center | 14219 W. Mc Nichols Road, Detroit, MI 48235 | 2012-10-05 |
| 1558619510 | St John Providence Eastwood Clinic | Clinic/Center | 4777 E Outer Dr Ste 1105, Detroit, MI 48234-3241 | 2012-08-23 |
| 1497997068 | Med Care Clinic LLC | Clinic/Center | 16315 Grand River Ave, Detroit, MI 48227-1825 | 2009-03-29 |
| 1841448446 | Theramatrix, Inc. | Clinic/Center | 18601 Mack Avenue #3, Detroit, MI 48236-3250 | 2008-09-08 |
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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.