Organization
MAAT MIHP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADJWOA CHIKE MA (EXECUTIVE)
(810) 986-2873
Entity
Organization
Contact information
Practice address
13560 E MCNICHOLS, DETROIT, MI 48205-3651
(248) 977-9948
Mailing address
13560 E MCNICHOLS RD, DETROIT, MI 48205-3426
(248) 977-9948
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
163W00000X
Registered Nurse
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922454537
—
MI
Enumeration date
05/12/2016
Last updated
02/21/2017
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