Poem Humanservice Development Corp.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1-00079 Issued in MI

Legal business name

POEM HUMANSERVICE DEVELOPMENT CORP.

Practice address

4720 Junction St
Detroit, MI 48210-2518

Phone

(313) 410-1829

Fax

(313) 896-1114

NPI assigned

Dec 13, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Emanuel Morris Taylor Jr., CACM

Title

President

Phone

(313) 896-7238

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1558544429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3372 18TH ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482082550",
            "telephone_number": "313-896-7238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 JUNCTION ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482102518",
            "telephone_number": "313-410-1829",
            "fax_number": "313-896-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POEM HUMANSERVICE DEVELOPMENT CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "EMANUEL",
        "authorized_official_middle_name": "MORRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-896-7238",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CACM"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": "1-00079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.