# NORTHEAST GUIDANCE CENTER

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

## Provider details

- **NPI number:** 1427336411
- **Authorized official:** SUE NEDERLANDER (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (313) 824-5642

## Contact information

- **Practice address:** 12800 E WARREN AVE, DETROIT, MI 48215-2061
- **Practice address phone:** (313) 824-8000
- **Practice address fax:** (313) 824-5589
- **Mailing address:** 2900 CONNER AVENUE, BLDG A, DETROIT, MI 48215
- **Mailing address phone:** (313) 308-1400
- **Mailing address fax:** (313) 308-1600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 07/26/2011
- **Last updated:** 07/26/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 21-3119549 | — | MI |