NPIMap

Organization Active NPI

300 W. McNichols

  • Substance Abuse Rehabilitation Facility
  • Detroit, MI
National Provider Identifier
1861892820
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
821264 Issued in MI
Legal business name
300 W. MCNICHOLS
Practice address
300 W McNichols Rd
Detroit, MI 48203-2703
Phone
(313) 867-8015
Fax
(313) 867-8040
NPI assigned
Aug 27, 2014
Last updated
Aug 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Authorized official

Name
Serge Jean Louis, MD
Title
Ceo
Phone
(313) 867-8015

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 821264 MI Primary

Addresses

Primary practice location

300 W McNichols Rd
Detroit, MI 48203-2703

Mailing address

300 W McNichols Rd
Detroit, MI 48203-2703
Phone (313) 867-8015

National Provider Directory

National Provider Directory
Tax ID family
Inspira Health Network13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1861892820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482032703",
            "telephone_number": "313-867-8015",
            "fax_number": "313-867-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482032703",
            "telephone_number": "313-867-8015",
            "fax_number": "313-867-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "300 W. MCNICHOLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "LOUIS",
        "authorized_official_first_name": "SERGE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-867-8015",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "821264",
            "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 Aug 27, 2014; 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.