ST JOHN PROVIDENCE HEALTH SYSTEMS (NPI# 1770821795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770821795 |
| Entity Type | Organization |
| Organization Name | ST JOHN PROVIDENCE HEALTH SYSTEMS |
| Practice Address |
1150 Lantz St Detroit MI 48203 |
| Mailing Address |
1150 E Lantz St Detroit MI 48203-1376 |
| Practice Telephone | 3133684267 |
| Practice Fax Number | 3133684470 |
| Mailing Telephone | 3133684267 |
| Mailing Fax Number | 3133684470 |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2013-01-25 |
| Authorized Official Name | MS. CYNTHIA ELIZABETH WILLIAMS (THERAPIST) |
| Authorized Official Telephone | 3133684267 |
| Authorized Official Credential | LLPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
1150 LANTZ ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992355135 | James Calloway | Peer Specialist | 1211 E Mcnichols, Detroit, MI 48203 | 2019-09-19 |
| 1851868582 | Community Veterans Services Inc | Counselor | 163 Tennyson, Highland Park, MI 48203 | 2018-10-31 |
| 1346601838 | Rainbow Center of Michigan | Health Maintenance Organization | 12501 Hamilton Ave., Highland Park, MI 48203 | 2016-03-11 |
| 1134502354 | Minds Moving In New Directions Inc | Community/Behavioral Health | 62 Massachusetts St, Highland Park, MI 48203 | 2015-07-07 |
| 1811312937 | Brea Holloway | Home Health | 20249 Yacama Rd, Detroit, MI 48203 | 2014-02-26 |
| 1871845412 | Waneta Darcell Dickerson | Social Worker | 169 W. Buena Vista, Highlandpark, MI 48203 | 2012-10-05 |
| 1629331939 | Maureen Connolly | Pediatrics | 77 Victor St, Highland Park, MI 48203 | 2012-06-21 |
| 1578850251 | Detroit Recovery Project | Community/Behavioral Health | 1121 East Mc Nichols, Detroit, MI 48203 | 2011-07-01 |
| 1265728414 | Barbara Suzanne Tyson | Home Health | 301 Glendale St, Apt B8, Highland Park, MI 48203 | 2011-06-27 |
| 1922206580 | Carol Prince | Dermatology | 1610 West Seven Mile Rd., Detroit, MI 48203 | 2007-07-05 |
| Find all providers in zip 48203 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336394 | Kcs Community Services Inc | Community/Behavioral Health | 16577 Muirland St, Detroit, MI 48221-3012 | 2020-11-04 |
| 1356988562 | Charlotte Yvonne Overall | Community/Behavioral Health | 13334 Longview St, Detroit, MI 48213-1919 | 2019-12-06 |
| 1477110054 | Reymac Home Healthcare LLC | Community/Behavioral Health | 13030 W 7 Mile Rd, Detroit, MI 48235-1335 | 2019-05-20 |
| 1033773528 | Great Futures Family Services Inc | Community/Behavioral Health | 11475 E Outer Dr, Detroit, MI 48224-3226 | 2019-04-30 |
| 1275197527 | Volunteers of America Michigan | Community/Behavioral Health | 3031 W Grand Blvd Ste 465, Detroit, MI 48202-3017 | 2019-04-23 |
| 1891271458 | Bwl Care, LLC | Community/Behavioral Health | 16861 Wyoming St, Detroit, MI 48221-2850 | 2018-07-17 |
| 1780189365 | Fayna T Counseling Services Pllc | Community/Behavioral Health | 5575 Conner St Ste 208, Detroit, MI 48213-6401 | 2018-03-27 |
| 1912400508 | Your Voice and Choice, Pllc | Community/Behavioral Health | 12241 Vaughan St, Detroit, MI 48228-1008 | 2018-03-09 |
| 1508365560 | Zion's Hope Social Services LLC | Community/Behavioral Health | 16860 Gardenview Cir Bldg C, Detroit, MI 48228-4319 | 2018-02-06 |
| 1073035473 | Creative Empowerment Counseling Services, LLC | Community/Behavioral Health | 214 Manistique, Detroit, MI 48215 | 2017-07-07 |
| 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.