Educating U4 Life CDC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

6801011686 Issued in MI

Legal business name

EDUCATING U4 LIFE CDC

Practice address

19321 W Chicago St
Detroit, MI 48228-1739

Phone

(877) 267-3491

NPI assigned

Apr 26, 2017

Last updated

Jul 25, 2019By 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

Mr. Albert Eugene Mack

Title

Executive Director

Phone

(877) 267-3491

Specialties & licenses 2

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Delores Guye

  • Clinical Social Worker
  • Detroit, MI
  • NPI 1659884773
  NPD (past)
• Glynn Merriewether

  • Mental Health Counselor
  • Detroit, MI
  • NPI 1922517838
  NPD (past)
• Yvonne Fannie West, LMSW

  • Clinical Social Worker
  • Detroit, MI
  • NPI 1750890687
  NPD (past)

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1336674415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22503 GRAND RIVER AVE",
            "address_2": "SUITE 19653",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482195034",
            "telephone_number": "877-267-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19321 W CHICAGO ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482281739",
            "telephone_number": "877-267-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUCATING U4 LIFE CDC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "877-267-3491",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "MI",
            "license": "6801046708",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "6801011686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edmond & Williams Co.LLC
• Alisa Edmonds-Hatten
• Alandis De'Ersula Edmonds
• Khalilah Edmondson
• Claudia Nicole Edmonson, SST, HSA
• Edward a Clay MD PC
• Edward G Kroll,DDS and Associates, PC
• Edward Roberts PLLC
• Edward Simmons Massage Therapists LLC
• Alicia Edwards, LLBSW

• Community/Behavioral Health Agency in Detroit, MI
• Providers in Detroit, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.