| Impact Community Services | |
|
18353 W Mcnichols Rd Suite #6 Detroit MI 48219-4199 | |
| (866) 538-2131 | |
| (855) 284-2226 |
| Full Name | Impact Community Services |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 18353 W Mcnichols Rd, Detroit, Michigan |
| Authorized Official Name and Position | Anitra Shawnta Smith (FOUNDER/CEO) |
| Authorized Official Contact | 18665382131 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Community Services 18701 Grand River Ave Suite 345 Detroit MICHIGAN 48223 Ph: (866) 538-2131 | Impact Community Services 18353 W Mcnichols Rd Suite #6 Detroit MI 48219-4199 Ph: (866) 538-2131 |
| NPI Number | 1992073548 |
|---|---|
| Provider Enumeration Date | 12/11/2011 |
| Last Update Date | 09/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992073548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801091775 (Michigan) | Primary |
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