NPIMap

Organization Active NPI

Circle of Life Outreach Services

  • Community/Behavioral Health Agency
  • Detroit, MI
National Provider Identifier
1255633699
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CIRCLE OF LIFE OUTREACH SERVICES
Practice address
15491 Troester St
Detroit, MI 48205-3566
Phone
(734) 961-2409
NPI assigned
Nov 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Authorized official

Name
Lawanda DraytonNPI 1861709206
Title
Co-Owner
Phone
(734) 961-2409

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MI Primary

Addresses

Primary practice location

15491 Troester St
Detroit, MI 48205-3566

Mailing address

15491 Troester
Detroit, MI 48205

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289952000000",
    "number": "1255633699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15491 TROESTER",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15491 TROESTER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482053566",
            "telephone_number": "734-961-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIRCLE OF LIFE OUTREACH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A",
        "authorized_official_last_name": "DRAYTON",
        "authorized_official_first_name": "LAWANDA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "734-961-2409"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": null,
            "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 Nov 17, 2010; 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.