DETROIT CENTRAL CITY COMMUNITY MENTAL HEALTH, INC. (NPI# 1730535808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730535808 |
| Entity Type | Organization |
| Organization Name | DETROIT CENTRAL CITY COMMUNITY MENTAL HEALTH, INC. |
| Other Organization Name | CENTRAL CITY INTEGRATED HEALTH |
| Practice Address |
3427 Woodward Ave Detroit MI 48201-2722 |
| Mailing Address |
17950 Woodward Ave Detroit MI 48203-2260 |
| Practice Telephone | 3138313160 |
| Practice Fax Number | 3138312604 |
| Mailing Telephone | 3138313160 |
| Mailing Fax Number | 3138260567 |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MR. RYAN LEPPER (CEO, PRESIDENT) |
| Authorized Official Telephone | 3138313160 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
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 | 3138313160 | 3138260567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861813685 | Detroit Central City Community Mental Health, Inc. | Clinic/Center | 17950 Woodward Ave, Detroit, MI 48203-2260 | 2013-12-20 |
| Street Address |
3427 WOODWARD AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2722 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770991796 | Veronica Smith | Nurse Practitioner | 3427 Woodward Ave, Detroit, MI 48201-2725 | 2014-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| 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.