Cobap Substance Abusetreatment & Prevention Program

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

820805 Issued in MI

Legal business name

COBAP SUBSTANCE ABUSETREATMENT & PREVENTION PROGRAM

Practice address

17357 Klinger St
Detroit, MI 48212-1035

Phone

(313) 893-4275

Fax

(313) 893-0713

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John W Marks Sr., MSW, ACSW,DR.MIN

Title

Executive Director

Phone

(313) 893-4275

Specialties & licenses 1

Addresses

Other names 1

• Council Of Baptist Pastors (COBAP) Other name

Locations

Practitioners 1

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.

• Bruce Belfonta Marks, CAC-M

  • Addiction (Substance Use Disorder) Counselor
  • Detroit, MI
  • NPI 1063733996
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1386778272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17357 KLINGER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121035",
            "telephone_number": "313-893-4275",
            "fax_number": "313-893-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17357 KLINGER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482121035",
            "telephone_number": "313-893-4275",
            "fax_number": "313-893-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBAP SUBSTANCE ABUSETREATMENT & PREVENTION PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "MARKS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "313-893-4275",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MSW, ACSW,DR.MIN"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "820805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Council Of Baptist Pastors (COBAP)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Courtnie Janine Coakley
• Guy Richard Coaster, NP-C
• Earnestine Coates, LMSW
• Erika Coates, MS, LLPC
• Era Cobani, MD
• Lakita Cobb-Elder
• Linda Suzanne Cobb-McClain, PHD
• Kathleen Mary Cobb, APRN, BC
• Kenneth Vance Cobb Jr., LMSW
• Latraya Denean Cobb, MA, LLP

• Substance Abuse Rehabilitation Facility in Detroit, MI
• Providers in Detroit, MI by specialty
• Substance Abuse Rehabilitation Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.