Detroit Family Center, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

6401009381 Issued in MI

Legal business name

DETROIT FAMILY CENTER, LLC

Practice address

24564 Raven Ave
Eastpointe, MI 48021-1408

Phone

(313) 525-0142

NPI assigned

Aug 17, 2011

Last updated

Aug 17, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Marcella Marea Payne Charley, MA, LLPC, CAADC

Title

Owner

Phone

(313) 208-9947

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1313539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313539200000",
    "number": "1174803571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24564 RAVEN AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480211408",
            "telephone_number": "313-525-0142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24564 RAVEN AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480211408",
            "telephone_number": "313-525-0142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT FAMILY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-17",
        "last_updated": "2011-08-17",
        "status": "A",
        "authorized_official_last_name": "PAYNE CHARLEY",
        "authorized_official_first_name": "MARCELLA",
        "authorized_official_middle_name": "MAREA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-208-9947",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, LLPC, CAADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6401009381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; 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.