Organization
DETROIT WAYNE COUNTY HEALTH AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORETTA BUSH (CEO)
(313) 871-3751
Entity
Organization
Contact information
Practice address
10809 MACK AVE, DETROIT, MI 48214-2119
(313) 824-1000
(313) 824-9000
Mailing address
3031 W GRAND BLVD, DETROIT, MI 48202-3046
(313) 824-1000
(313) 824-9000
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
251K00000X
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
3336C0002X
Clinic Pharmacy
—
—
Other
Enumeration date
01/29/2010
Last updated
12/01/2025
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