Organization
DETROIT RECEIVING HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLORIA LARKINS VICE PRESIDENT (VICE PRESIDENT FINANCE)
(313) 578-2164
Entity
Organization
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 578-2164
(313) 578-3964
Mailing address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(313) 578-2164
(313) 578-3964
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H21525
BCBSM PROVIDER ID
MI
Enumeration date
06/07/2007
Last updated
08/22/2020
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