KENNETH DEON BLUE CADCM NPI 1518236116

NPI Information

  • NPI: 1518236116
  • Provider Name: KENNETH DEON BLUE, CADCM
  • Classification: Substance Abuse Rehabilitation Facility - 324500000X
  • Entity Type: Individual
  • Address: 12305 DEXTER AVE
    DETROIT, MI
    ZIP 48206
  • Phone: (313) 397-1306

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NPI Details

Kenneth Deon Blue, CADCM is a substance abuse rehabilitation facility in Detroit, MI. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. Kenneth Deon Blue, CADCM NPI is 1518236116. 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:

12305 DEXTER AVE
DETROIT, MI
ZIP 48206-015
Phone: (313) 397-1306
Fax: (313) 397-6010

The enumeration date for this NPI number is 12/28/2011 and was last updated on 12/28/2011.

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
1324500000XSubstance Abuse Rehabilitation FacilityYes

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: 3/30/2025

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