NPIMap

Organization Active NPI

Elmhurst Home, Inc.

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
National Provider Identifier
1366659906
Registry record updated Jan 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
820202 Issued in MI
Legal business name
ELMHURST HOME, INC.
Practice address
12010 Linwood St
Detroit, MI 48206-1108
Phone
(313) 867-1002
Fax
(313) 867-7776
NPI assigned
May 16, 2007
Last updated
Jan 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2026

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

Authorized official

Name
Mr. John Campbell Oden
Title
Executive Director
Phone
(313) 867-1002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 820202 MI Primary

Addresses

Primary practice location

12010 Linwood St
Detroit, MI 48206-1108

Mailing address

12010 Linwood St
P. O. Box 06716
Detroit, MI 48206-1108
Phone (313) 867-1002

Other practice location 1

245 Pitkin St
Highland Park, MI 48203-3737
Phone (313) 865-1500

Other names 1

  • Elmhurst Home, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230106000299 MI Part B Supplier - Clinic/Group Practice 5395115489 Receives reassigned benefits from 5 practitioners
Practice locations: Detroit, MI; Highland Park, MI

National Provider Directory

National Provider Directory
Tax ID family
Elmhurst Home Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12010 Linwood St
Detroit, MI 48206
Phone (313) 752-6308

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768262400000",
    "number": "1366659906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12010 LINWOOD ST",
            "address_2": "P. O. BOX 06716",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061108",
            "telephone_number": "313-867-1002",
            "fax_number": "313-867-7776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12010 LINWOOD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482061108",
            "telephone_number": "313-867-1002",
            "fax_number": "313-867-7776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Pitkin St",
            "address_purpose": "LOCATION",
            "city": "Highland Park",
            "state": "MI",
            "postal_code": "482033737",
            "country_code": "US",
            "telephone_number": "313-865-1500",
            "fax_number": "313-865-1477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELMHURST HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2026-01-13",
        "certification_date": "2026-01-13",
        "status": "A",
        "authorized_official_last_name": "ODEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CAMPBELL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "313-867-1002",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "820202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elmhurst Home, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Elmhurst Home, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jan 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.