Organization
IMPACT COMMUNITY HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATRICE MCCLENDON (MIHP COORDINATOR)
(734) 642-5498
Entity
Organization
Contact information
Practice address
16200 ROSEMONT AVE, DETROIT, MI 48219-4168
(734) 642-5498
(313) 731-0613
Mailing address
PO BOX 23734, DETROIT, MI 48223-0734
(734) 642-5498
(313) 731-0613
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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