Manna of Detroit Inc.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

822416 Issued in MI

Legal business name

MANNA OF DETROIT INC.

Practice address

12048 Grand River Ave
Detroit, MI 48204-1836

Phone

(313) 491-2956

Fax

(313) 491-0616

NPI assigned

Nov 17, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Marvin Chiles Thomas, MA CACII NCGC SWT

Title

Executive Director

Phone

(313) 491-2956

Specialties & licenses 1

Addresses

Tax ID family

Manna of Detroit2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Manna of Detroit

  • Addiction (Substance Use Disorder) Counselor
  • Detroit, MI
  • NPI 1215092390
  NPD tax ID

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629050471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20696",
            "address_2": "12048 GRAND RIVER, DET.MI 48204",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482200696",
            "telephone_number": "313-491-2956",
            "fax_number": "313-491-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12048 GRAND RIVER AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482041836",
            "telephone_number": "313-491-2956",
            "fax_number": "313-491-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANNA OF DETROIT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "CHILES",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "313-491-2956",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA CACII NCGC SWT"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "822416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Ann Mann, MSN, FNP-BC, CDE
• Lashawn Patrice Mann
• William Mann
• Yasmeen Kaur Mann
• Manna of Detroit
• Ali Hassan Mannaa, MD
• Vijay Krishna Manne, M.D.
• Nitya Manney
• Ramya Manney, M.D.
• Kain Michael Manning

• Addiction (Substance Use Disorder) Counselor in Detroit, MI
• Providers in Detroit, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.