Old Redford Treatment Center Inc

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

OLD REDFORD TREATMENT CENTER INC

Practice address

23001 Grand River Ave
Detroit, MI 48219-3130

Phone

(313) 614-8000

NPI assigned

Sep 13, 2025

Organization subpart

No

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

Authorized official

Name

Anthony Fuller

Title

Ceo

Phone

(313) 614-8000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1757721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1356212443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23001 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23001 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482193130",
            "telephone_number": "313-614-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD REDFORD TREATMENT CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-13",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-614-8000"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ifeoluwa Christiana Olakunle
• Oluwafikayo Olamigoke
• Marwa Olayan, RDH
• Cynthia Marie Olberg-Treharne
• Onur Olcucu
• Cheryl Anice Olden, MS
• Kary Oldham
• Tayler Jeanine Oldham
• Julie Olesko, BS
• Kaitlin M Olexsey, D.O.

• Methadone Clinic in Detroit, MI
• Providers in Detroit, MI by specialty
• Methadone Clinic in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.