NPIMap

Organization Active NPI

Gateway-Detroit East

  • Community/Behavioral Health Agency
  • Detroit, MI
National Provider Identifier
1669759668
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GATEWAY-DETROIT EAST
Doing business as
Detroit East Health Services
Practice address
6309 Mack Ave
Detroit, MI 48207-2302
Phone
(313) 921-4700
NPI assigned
Nov 4, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Authorized official

Name
Dr. Radwan Khoury, PH.D
Title
Group Head
Phone
(313) 331-3435

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

6309 Mack Ave
Detroit, MI 48207-2302

Mailing address

6309 Mack Ave
Detroit, MI 48207-2302
Phone (313) 921-4700

Other names 1

  • Detroit East Health Services Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1669759668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072302",
            "telephone_number": "313-921-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482072302",
            "telephone_number": "313-921-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATEWAY-DETROIT EAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-04",
        "last_updated": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "KHOURY",
        "authorized_official_first_name": "RADWAN",
        "authorized_official_title_or_position": "GROUP HEAD",
        "authorized_official_telephone_number": "313-331-3435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Detroit East Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 30, 2015; 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.