Conner Creek Life Solutions LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

SA0823265 Issued in MI

Legal business name

CONNER CREEK LIFE SOLUTIONS LLC

Practice address

4777 E Outer Dr
Detroit, MI 48234-3241

Phone

(313) 369-5800

Fax

(313) 859-2000

NPI assigned

Jun 27, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Andrew McLemore Jr.

Title

Ceo

Phone

(313) 369-5800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1164917639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4777 EAST OUTER DRIVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48234",
            "telephone_number": "313-369-5800",
            "fax_number": "313-859-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4777 E OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482343241",
            "telephone_number": "313-369-5800",
            "fax_number": "313-859-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNER CREEK LIFE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-27",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "MCLEMORE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-369-5800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "SA0823265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Detroit, MI
• Providers in Detroit, MI by specialty
• Substance Abuse Rehabilitation Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; 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.