Provider Demographics
NPI:1225485329
Name:CREATING OPPORTUNITIES FOR INFANTS CHILDREN AND EXPECTANT MOTHERS
Entity Type:Organization
Organization Name:CREATING OPPORTUNITIES FOR INFANTS CHILDREN AND EXPECTANT MOTHERS
Other - Org Name:C.H.O.I.C.E.S. M.I.H.P.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TAMIKO
Authorized Official - Middle Name:DU-SHEAN
Authorized Official - Last Name:CONNER
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW
Authorized Official - Phone:313-854-7086
Mailing Address - Street 1:3701 15TH ST
Mailing Address - Street 2:221
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48208-2586
Mailing Address - Country:US
Mailing Address - Phone:313-854-7086
Mailing Address - Fax:
Practice Address - Street 1:12150 SCHAEFER HWY
Practice Address - Street 2:APT 108
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48227-3491
Practice Address - Country:US
Practice Address - Phone:313-854-7086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801094586251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare