MR. HAROLD ALPHONSO RUDOLPH NPI 1346588076

NPI Information

  • NPI: 1346588076
  • Provider Name: MR. HAROLD ALPHONSO RUDOLPH
  • Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
  • Entity Type: Individual
  • Address: 1852 W GRAND BLVD
    DETROIT, MI
    ZIP 48208
  • Phone: (313) 894-8444

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NPI Details

MR. Harold Alphonso Rudolph is a community based residential treatment facility mental illness in Detroit, MI. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. MR. Harold Alphonso Rudolph NPI is 1346588076. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1852 W GRAND BLVD
DETROIT, MI
ZIP 48208-006
Phone: (313) 894-8444
Fax: (313) 894-5542

The enumeration date for this NPI number is 1/31/2013 and was last updated on 1/31/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320800000XCommunity Based Residential Treatment Facility, Mental Illness820174MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1381917278MEDICAIDMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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