Individual
ANDRE ICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QMHS
Contact information
Practice address
79 W ALEXANDRINE ST, DETROIT, MI 48201-2015
(313) 831-5535
(313) 831-2608
Mailing address
79 W ALEXANDRINE ST, DETROIT, MI 48201-2015
(313) 831-5535
(313) 831-2608
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
MI
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/23/2024
Last updated
03/09/2026
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