Provider Demographics
NPI:1114520806
Name:S.A.Y DETROIT HEALTH CLINIC
Entity Type:Organization
Organization Name:S.A.Y DETROIT HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAWANA
Authorized Official - Middle Name:
Authorized Official - Last Name:NETTLES-ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-758-6100
Mailing Address - Street 1:211 GLENDALE ST STE 1000
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48203-3231
Mailing Address - Country:US
Mailing Address - Phone:313-758-6100
Mailing Address - Fax:
Practice Address - Street 1:211 GLENDALE ST STE 1000
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:MI
Practice Address - Zip Code:48203-3231
Practice Address - Country:US
Practice Address - Phone:313-758-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:S.A.Y DETROIT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health