NPIMap

Organization Active NPI

Detroit Recovery Project

  • Community/Behavioral Health Agency
  • Detroit, MI
National Provider Identifier
1578850251
Registry record updated Sep 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DETROIT RECOVERY PROJECT
Practice address
1121 East MC Nichols
Detroit, MI 48203
Phone
(313) 365-3113
Fax
(313) 365-3098
NPI assigned
Jul 1, 2011
Last updated
Sep 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2013

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

Authorized official

Name
Mrs. Virdell Faustina Thomas, MSW, LMSWNPI 1659422848
Title
Clinical Director
Phone
(313) 365-3113

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1121 East MC Nichols
Detroit, MI 48203

Mailing address

1121 East MC Nichols
Detroit, MI 48203
Phone (313) 365-3113

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200731002030 MI Part B Supplier - Clinic/Group Practice 1850716226 Receives reassigned benefits from 14 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Detroit, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D1053569Detroit Recovery Project1121 E MC Nichols Road, Detroit, MI 48203Certificate of waiverJan 7, 2027

National Provider Directory

National Provider Directory
Tax ID family
Detroit Recovery Project Incorporated5 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.

Locations

1145 W Grand Blvd
Detroit, MI 48208
Phone (313) 324-8900

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1309478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380153600000",
    "number": "1578850251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 EAST MC NICHOLS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48203",
            "telephone_number": "313-365-3113",
            "fax_number": "313-365-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 EAST MC NICHOLS",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48203",
            "telephone_number": "313-365-3113",
            "fax_number": "313-365-3098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT RECOVERY PROJECT",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-01",
        "last_updated": "2013-09-26",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "VIRDELL",
        "authorized_official_middle_name": "FAUSTINA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "313-365-3113",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "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 Sep 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.