NPIMap

Organization Active NPI

Cherry Streat Health Services

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
National Provider Identifier
1003180902
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
822051 Issued in MI
Legal business name
CHERRY STREAT HEALTH SERVICES
Practice address
11105 E Jefferson Ave
Detroit, MI 48214-3317
Phone
(313) 822-4060
Fax
(313) 822-1130
NPI assigned
Feb 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Avery E. Brown Jr., MA, LPC, CAAC, ICAAD
Title
Clinical Supervisor
Phone
(313) 822-4060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 822051 MI Primary

Addresses

Primary practice location

11105 E Jefferson Ave
Detroit, MI 48214-3317

Mailing address

11105 E Jefferson Ave
Detroit, MI 48214-3317
Phone (313) 822-4060

National Provider Directory

National Provider Directory
Tax ID family
Employee Assistance Center Fulton29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330041600000",
    "number": "1003180902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11105 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143317",
            "telephone_number": "313-822-4060",
            "fax_number": "313-822-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11105 E JEFFERSON AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482143317",
            "telephone_number": "313-822-4060",
            "fax_number": "313-822-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY STREAT HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-24",
        "last_updated": "2012-02-24",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "AVERY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CLINICAL SUPERVISOR",
        "authorized_official_telephone_number": "313-822-4060",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MA, LPC, CAAC, ICAAD"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "822051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.