Provider Demographics
NPI:1225597669
Name:STOP THE VIOLENCE PREVENTION OUTREACH PROGRAM
Entity Type:Organization
Organization Name:STOP THE VIOLENCE PREVENTION OUTREACH PROGRAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONFLICT RESOLUTION CONSULTANT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DOCTORATE DIVINITY
Authorized Official - Phone:313-221-3000
Mailing Address - Street 1:28820 SOUTHFIELD RD STE 124
Mailing Address - Street 2:
Mailing Address - City:LATHRUP VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2775
Mailing Address - Country:US
Mailing Address - Phone:313-221-3000
Mailing Address - Fax:844-500-0445
Practice Address - Street 1:28820 SOUTHFIELD RD STE 124
Practice Address - Street 2:
Practice Address - City:LATHRUP VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48076-2775
Practice Address - Country:US
Practice Address - Phone:313-221-3000
Practice Address - Fax:844-500-0445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty