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Organization

MANNA OF DETROIT INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARVIN CHILES THOMAS MA CACII NCGC SWT (EXECUTIVE DIRECTOR)
(313) 491-2956
Entity
Organization

Contact information

Practice address
12048 GRAND RIVER AVE, DETROIT, MI 48204-1836
(313) 491-2956
(313) 491-0616
Mailing address
PO BOX 20696, 12048 GRAND RIVER, DET.MI 48204, FERNDALE, MI 48220-0696
(313) 491-2956
(313) 491-0616

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
822416
MI

Other

Enumeration date
11/17/2005
Last updated
08/22/2020
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