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Organization

DETROIT INSTITUTE FOR CHILDREN

Active
Parent organization
THE DETROIT INSTITUTE FOR CHILDREN
Other names
Pediatric Potentials
Organization subpart
Yes

Provider details

NPI number
Legal business name
THE DETROIT INSTITUTE FOR CHILDREN
Authorized official
MR. MARK CLEARY (PRESIDENT/CEO)
(313) 832-1100
Entity
Organization

Contact information

Practice address
19505 E 8 MILE RD, SAINT CLAIR SHORES, MI 48080-1643
(586) 445-8200
(586) 445-8201
Mailing address
19505 E 8 MILE RD, SAINT CLAIR SHORES, MI 48080-1643
(586) 445-8200
(586) 445-8201

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
261QM1300X
Multi-Specialty Clinic/Center

Other

Enumeration date
01/06/2011
Last updated
04/04/2013
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