MANNA OF DETROIT INC. (NPI# 1629050471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629050471 |
| Entity Type | Organization |
| Organization Name | MANNA OF DETROIT INC. |
| Practice Address |
12048 Grand River Ave Detroit MI 48204-1836 |
| Mailing Address |
Po Box 20696 12048 Grand River, Det.mi 48204 Ferndale MI 48220-0696 |
| Practice Telephone | 3134912956 |
| Practice Fax Number | 3134910616 |
| Mailing Telephone | 3134912956 |
| Mailing Fax Number | 3134910616 |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MARVIN CHILES THOMAS (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3134912956 |
| Authorized Official Credential | MA CACII NCGC SW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
822416 | MI | Behavioral Health & Social Service Providers |
| Street Address |
12048 GRAND RIVER AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48204-1836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841851615 | J. Lewis Development Corporation | Day Training, Developmentally Disabled Services | 12048 Grand River Ave, Detroit, MI 48204-1836 | 2019-06-24 |
| 1235601170 | The Detroit Association of Black Organizations (dabo), Inc. | Early Intervention Provider Agency | 12048 Grand River Ave, Detroit, MI 48204-1836 | 2018-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033763347 | Latrese Tucker | Contractor | 9600 Wyoming, Detroit, MI 48204 | 2019-07-25 |
| 1023477296 | Lloyd Tender Care LLC | Home Health | 8360 Alpine, Detroit, MI 48204 | 2016-02-17 |
| 1104132703 | Chelseas Home Care | Custodial Care Facility | 12391 Birwood, Detroit, MI 48204 | 2010-08-20 |
| 1407001332 | Wards Holy Management Outreach Church | Point of Service | 12410 Wyoming St Fl 2, Detroit, MI 48204 | 2008-11-19 |
| 1346498250 | Jamila B Boulaalam | Dentist | 9685 Gd River, Detroit, MI 48204 | 2008-09-04 |
| 1245427186 | Hollis Whitcliffe James | Dentist | 10241 Joy Road, Detroit, MI 48204 | 2007-09-25 |
| 1861510679 | Roger James Gregory | Counselor | 9605 West Grand River, Nardin Park Recovery Center, Detroit, MI 48204 | 2007-03-27 |
| 1558464743 | Gerald Jacob Najor | Pharmacist | 7350 Grand River, Fraser Drugs, Detroit, MI 48204 | 2006-09-06 |
| 1255449740 | Deborah Oliver | Dentist | 8325 Grand River, Detroit, MI 48204 | 2006-08-26 |
| 1427148618 | Rite- Way Hardware Inc | Pharmacy | 7350 Grand River, Detroit, MI 48204 | 2006-10-16 |
| Find all providers in zip 48204 | ||||
| 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 |
| 1205304359 | Life Challenge of Southeastern Michigan | Counselor | 17667 Pierson St, Detroit, MI 48219-2520 | 2018-11-07 |
| 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 |
| 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.