Organization
Y.A.D.
Active
Parent organization
EMMANUEL HOUSE 1&2 INC.
Other names
Emmanuel House 1&2 Inc.
Organization subpart
Yes
Provider details
NPI number
Legal business name
EMMANUEL HOUSE 1&2 INC.
Authorized official
MRS. BLANCHE RENEE FOSTER (EXECUTIVE DIRECTOR)
(313) 729-4547
Entity
Organization
Contact information
Practice address
18425 HICKORY ST, DETROIT, MI 48205-2707
(313) 729-4547
(313) 821-8683
Mailing address
PO BOX 13185, DETROIT, MI 48213-0185
(313) 729-4547
(313) 821-8683
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
261QA0600X
MI
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
261QR0405X
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2387424
—
MI
Enumeration date
02/17/2011
Last updated
02/17/2011
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