Organization
PROGRESS TRANSITIONALNONPROFIT HOUSING CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUAN CLARK (PRESIDENT, BOARD OF DIRECTORS)
(313) 350-2863
Entity
Organization
Contact information
Practice address
13500 E. MCNICHOLS ROAD, DETROIT, MI 48205-3426
(313) 647-4559
(313) 255-3947
Mailing address
13500 E. MCNICHOLS ROAD, DETROIT, MI 48205-3426
(313) 647-4559
(313) 255-3947
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4704276788
MI
101YM0800X
Mental Health Counselor
4704276788
MI
101YM0800X
Mental Health Counselor
6801086770
MI
104100000X
Social Worker
4704276788
MI
163WC0400X
Case Management Registered Nurse
4704276788
MI
163WG0000X
General Practice Registered Nurse
4704276788
MI
251S00000X
Community/Behavioral Health Agency
Primary
822974
MI
Other
Enumeration date
02/08/2012
Last updated
03/17/2017
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