DETROIT COMMUNITY HEALTH CONNECTION INC. NPI 1982611562

NPI Information

NPI: 1982611562
Provider Name: DETROIT COMMUNITY HEALTH CONNECTION, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
13901 E JEFFERSON AVE
DETROIT, MI
ZIP 48215
Phone: (313) 822-0900
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DETROIT COMMUNITY HEALTH CONNECTION, INC. is a federally qualified health center (fqhc) clinic center in Detroit, MI. DETROIT COMMUNITY HEALTH CONNECTION, INC. NPI is 1982611562. The provider is registered as an organization entity type.

The provider's business location address is:

13901 E JEFFERSON AVE
DETROIT, MI
ZIP 48215-720
Phone: (313) 822-0900
Fax: (313) 822-0950

The provider's authorized official is Mahipal Rao Kakarala .
The authorized official title is Cfo and has the following contact phone number (313) 821-2591.

The enumeration date for this NPI number is 8/3/2006 and was last updated on 6/24/2015.

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
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

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
1	1982611562	OTHER		NPI
2	231802	MEDICARE OSCAR/CERTIFICATION
3	1992196	MEDICAID	MICHIGAN

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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