NPIMap

Organization Active NPI

Detroit Rescue Mission Ministries

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
National Provider Identifier
1063545556
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
821050 Issued in MI
Legal business name
DETROIT RESCUE MISSION MINISTRIES
Practice address
3840 Fairview St
Detroit, MI 48214-1608
Phone
(313) 331-8990
Fax
(313) 331-6375
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Chad Audi
Title
Chief Executive Officer
Phone
(313) 993-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 821050 MI Primary

Addresses

Primary practice location

3840 Fairview St
Detroit, MI 48214-1608

Mailing address

150 Stimson St
Detroit, MI 48201-2410
Phone (313) 993-4700

Other identifiers 1

IdentifierTypeStateIssuer
3022440MedicaidMI

Other names 1

  • Genesis House Three Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Detroit Rescue Mission Ministry7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

3840 Fairview St
Detroit, MI 48214
Phone (313) 331-8890

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063545556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 STIMSON ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012410",
            "telephone_number": "313-993-4700",
            "fax_number": "313-831-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 FAIRVIEW ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482141608",
            "telephone_number": "313-331-8990",
            "fax_number": "313-331-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT RESCUE MISSION MINISTRIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AUDI",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "313-993-4700",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "821050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3022440",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Genesis House Three",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.