| Manna Of Detroit Inc. | |
|
12048 Grand River Ave Detroit MI 48204-1836 | |
| (313) 491-2956 | |
| (313) 491-0616 |
| Full Name | Manna Of Detroit Inc. |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 12048 Grand River Ave, Detroit, Michigan |
| Authorized Official Name and Position | Marvin Chiles Thomas (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3134912956 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Manna Of Detroit Inc. Po Box 20696 12048 Grand River, Det.mi 48204 Ferndale MI 48220-0696 Ph: (313) 491-2956 | Manna Of Detroit Inc. 12048 Grand River Ave Detroit MI 48204-1836 Ph: (313) 491-2956 |
| NPI Number | 1629050471 |
|---|---|
| Provider Enumeration Date | 11/17/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629050471 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 822416 (Michigan) | Primary |
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