NPIMap

Organization Active NPI

Pure Recovery Inc.

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
National Provider Identifier
1861778680
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
823101 Issued in MI
Legal business name
PURE RECOVERY INC.
Practice address
19406 Norwood St
Detroit, MI 48234-1870
Phone
(313) 231-6049
NPI assigned
Oct 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Authorized official

Name
Mr. Phillip Simmons, LPCNPI 1386824670
Title
Program Director
Phone
(313) 231-6049

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 823101 MI Primary

Addresses

Primary practice location

19406 Norwood St
Detroit, MI 48234-1870

Mailing address

20490 Harper Ave
Suite 113
Harper Woods, MI 48225-1645

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319500800000",
    "number": "1861778680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20490 HARPER AVE",
            "address_2": "SUITE 113",
            "city": "HARPER WOODS",
            "state": "MI",
            "postal_code": "482251645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19406 NORWOOD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341870",
            "telephone_number": "313-231-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE RECOVERY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "313-231-6049",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "823101",
            "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 Oct 25, 2011; 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.