NPIMap

Organization Active NPI

Detroit Health Care for the Homeless

Doing business as Advantage Health Centers

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
National Provider Identifier
1871645309
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
DETROIT HEALTH CARE FOR THE HOMELESS
Doing business as
Advantage Health Centers
Practice address
15400 W McNichols Rd
Detroit, MI 48235-3724
Phone
(313) 835-5990
Fax
(313) 221-8217
NPI assigned
Jan 17, 2007
Last updated
Apr 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Authorized official

Name
Nina Abubakari
Title
Ceo
Phone
(313) 416-6259

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X MI Primary

Addresses

Primary practice location

15400 W McNichols Rd
Detroit, MI 48235-3724

Mailing address

100 River Place Dr Ste 450
Detroit, MI 48207-5402
Phone (313) 416-6200

Other names 1

  • Advantage Health Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040226000898 MI Part A Provider - Federally Qualified Health Center (FQHC) 2668368572 Practice locations: Detroit, MI
O20040526000397 MI Part B Supplier - Clinic/Group Practice 2668368572 Receives reassigned benefits from 14 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Detroit, MI; Warren, MI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1871645309. Details of each certification follow.

Federally qualified health center certification: CCN 231893

Legal name
DETROIT HEALTH CARE FOR THE HOMELESS
Doing business as
ADVANTAGE HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Apr 27, 2004
Last certification
Apr 27, 2004
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Oct 30, 1986 in MI
Enrollment address
15400W McNichols Rd
Detroit, MI 48235-3724

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

Locations

100 River Place Dr
Ste 450
Detroit, MI 48207

4669 E 8 Mile Rd
Ste 0
Warren, MI 48091

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stacie Durant Individual Corporate OfficerTreasurer Jan 1, 2019
Lisa Berden Individual Corporate DirectorBoard Member Mar 1, 2021
Nina Abubakari Individual Corporate Director Jun 27, 2016
W-2 Managing Employee Jun 27, 2016
Eric Brown Individual Corporate DirectorBoard Secretary Mar 1, 2020
Charles Felton Individual Corporate DirectorBoard President Feb 1, 2018

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1871645309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIVER PLACE DR STE 450",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482075402",
            "telephone_number": "313-416-6200",
            "fax_number": "313-221-8217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15400 W MCNICHOLS RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482353724",
            "telephone_number": "313-835-5990",
            "fax_number": "313-221-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT HEALTH CARE FOR THE HOMELESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "ABUBAKARI",
        "authorized_official_first_name": "NINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-416-6259"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Health Centers",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advantage Health Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.