# MANNA OF DETROIT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215092390
- **Authorized official:** MR. MARVIN CHILES THOMAS MA CACII SWT (EXECUTIVE DIR.)
- **Authorized official phone:** (313) 334-9375

## Contact information

- **Practice address:** 8501 WOODWARD AVE, DETROIT, MI 48202-2236
- **Practice address phone:** (313) 872-3639
- **Practice address fax:** (313) 872-3639
- **Mailing address:** PO BOX 20696, FERNDALE, MI 48220-0696
- **Mailing address phone:** (313) 872-3639

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 822416 | MI | Yes |

## Other

- **Enumeration date:** 12/27/2006
- **Last updated:** 08/22/2020