THE GREAT DIVINE CENTER LLC NPI 1902558091

NPI Information

NPI: 1902558091
Provider Name: THE GREAT DIVINE CENTER LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
17169 E WARREN AVE
DETROIT, MI
ZIP 48224
Phone: (313) 480-4766
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THE GREAT DIVINE CENTER LLC is a mental health counselor in Detroit, MI. THE GREAT DIVINE CENTER LLC NPI is 1902558091. The provider is registered as an organization entity type.

The provider's business location address is:

17169 E WARREN AVE
DETROIT, MI
ZIP 48224-279
Phone: (313) 480-4766

The provider's authorized official is Kymaletha Brown .
The authorized official title is Counselor/owner and has the following contact phone number (313) 480-4766.

The enumeration date for this NPI number is 1/20/2022 and was last updated on 1/20/2022.

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	Primary
1	261QC1500X	Clinic/Center	Community Health	No
2	261QM1300X	Clinic/Center	Multi-Specialty	No
3	101YM0800X	Counselor	Mental Health	Yes

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: 11/14/2023

NPI Synchronization or Removal

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