NPIMap

Organization Active NPI

Detroit Area Agency on Aging

  • Case Management Agency
  • Detroit, MI
National Provider Identifier
1023252152
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
DETROIT AREA AGENCY ON AGING
Practice address
1333 Brewery Park Blvd Ste 200
Detroit, MI 48207-4544
Phone
(313) 446-4444
Fax
(313) 446-4445
NPI assigned
Apr 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Authorized official

Name
Mr. Paul Bridgewater
Title
President & Ceo
Phone
(313) 446-4444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

1333 Brewery Park Blvd Ste 200
Detroit, MI 48207-4544

Mailing address

1333 Brewery Park Blvd Ste 200
Detroit, MI 48207-4544
Phone (313) 446-4444

Other identifiers 1

IdentifierTypeStateIssuer
4509511MedicaidMI

National Provider Directory

National Provider Directory
Tax ID family
Detroit Area Agency on Aging2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1333 Brewery Park Blvd
Ste 200
Detroit, MI 48207
Phone (313) 446-4444

NPI Registry JSON

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

{
    "created_epoch": "1240185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240185600000",
    "number": "1023252152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 BREWERY PARK BLVD STE 200",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074544",
            "telephone_number": "313-446-4444",
            "fax_number": "313-446-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 BREWERY PARK BLVD STE 200",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482074544",
            "telephone_number": "313-446-4444",
            "fax_number": "313-446-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT AREA AGENCY ON AGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-20",
        "last_updated": "2009-04-20",
        "status": "A",
        "authorized_official_last_name": "BRIDGEWATER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "313-446-4444",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4509511",
            "state": "MI"
        }
    ],
    "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 Apr 20, 2009; 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.