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Organization
MANNA OF DETROIT INC.
Active
Organization
MANNA OF DETROIT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIN CHILES THOMAS MA CACII NCGC SWT (EXECUTIVE DIRECTOR)
(313) 491-2956
Entity
Organization
Contact information
Practice address
12048 GRAND RIVER AVE, DETROIT, MI 48204-1836
(313) 491-2956
(313) 491-0616
Mailing address
PO BOX 20696, 12048 GRAND RIVER, DET.MI 48204, FERNDALE, MI 48220-0696
(313) 491-2956
(313) 491-0616
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
822416
MI
Other
Enumeration date
11/17/2005
Last updated
08/22/2020
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