Organization
DETROIT COMMUNITY HEALTH CONNECTION, INC
Active
Parent organization
DETROIT COMMUNITY HEALTH CONNECTION, INC.
Other names
Oscar Paskal Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
DETROIT COMMUNITY HEALTH CONNECTION, INC.
Authorized official
MR. MAHIPAL RAO KAKARALA (SRVP/CFO)
(313) 821-2591
Entity
Organization
Contact information
Practice address
12800 E WARREN AVE, DETROIT, MI 48215-2061
(313) 343-2887
(313) 343-2889
Mailing address
12800 E WARREN AVE, DETROIT, MI 48215-2061
(313) 343-2887
(313) 343-2889
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992196
—
MI
01
—
ON30150
MEDICARE ID
MI
Enumeration date
07/22/2011
Last updated
07/08/2015
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