Organization
MANNA OF DETROIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIN CHILES THOMAS MA CACII SWT (EXECUTIVE DIR.)
(313) 334-9375
Entity
Organization
Contact information
Practice address
8501 WOODWARD AVE, DETROIT, MI 48202-2236
(313) 872-3639
(313) 872-3639
Mailing address
PO BOX 20696, FERNDALE, MI 48220-0696
(313) 872-3639
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
822416
MI
Other
Enumeration date
12/27/2006
Last updated
08/22/2020
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