Provider Demographics
NPI:1174866073
Name:CARE AND TRANSFORMATION CENTER
Entity Type:Organization
Organization Name:CARE AND TRANSFORMATION CENTER
Other - Org Name:CTC
Other - Org Type:Other Name
Authorized Official - Title/Position:FOUNDER AND PRESEDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAITHAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAFO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:313-283-7981
Mailing Address - Street 1:2311 15 MILE RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4842
Mailing Address - Country:US
Mailing Address - Phone:586-983-9280
Mailing Address - Fax:586-275-0612
Practice Address - Street 1:2311 15 MILE RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-6462
Practice Address - Country:US
Practice Address - Phone:586-983-9280
Practice Address - Fax:586-275-0612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-29
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009738251S00000X, 261QM0801X, 261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1124392071OtherINDIVIDULE NPI