Provider Demographics
NPI:1346618329
Name:MORGANSCARELLC
Entity Type:Organization
Organization Name:MORGANSCARELLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOCIAL SERVICE TECHINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:BA SST
Authorized Official - Phone:313-728-3620
Mailing Address - Street 1:8530 WHITCOMB ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48228-2256
Mailing Address - Country:US
Mailing Address - Phone:313-728-3620
Mailing Address - Fax:
Practice Address - Street 1:8530 WHITCOMB ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48228-2256
Practice Address - Country:US
Practice Address - Phone:313-728-3620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization