NPIMap

Organization Active NPI

Northeast Guidance Center

  • Health Maintenance Organization
  • Detroit, MI
National Provider Identifier
1386881050
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
R 120744734409 Issued in MI
Legal business name
NORTHEAST GUIDANCE CENTER
Practice address
12800 E Warren Ave
Detroit, MI 48215-2061
Phone
(313) 824-8000
Fax
(313) 824-5589
NPI assigned
Jan 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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

Authorized official

Name
Ms. Trina Dixon
Title
Ceo
Phone
(313) 824-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X R 120744734409 MI Primary

Addresses

Primary practice location

12800 E Warren Ave
Detroit, MI 48215-2061

Mailing address

12800 E Warren Ave
Detroit, MI 48215-2061
Phone (313) 824-8000

National Provider Directory

National Provider Directory
Tax ID family
Northeast Guidance Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232064000000",
    "number": "1386881050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152061",
            "telephone_number": "313-824-8000",
            "fax_number": "313-824-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482152061",
            "telephone_number": "313-824-8000",
            "fax_number": "313-824-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GUIDANCE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "TRINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-824-8000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MI",
            "license": "R 120744734409",
            "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 Jan 16, 2009; 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.