Provider Demographics
NPI:1346866167
Name:GOD'S PATH COMMUNITY SERVICES
Entity Type:Organization
Organization Name:GOD'S PATH COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:313-473-9573
Mailing Address - Street 1:1728 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48214-2410
Mailing Address - Country:US
Mailing Address - Phone:313-676-3271
Mailing Address - Fax:
Practice Address - Street 1:2500 LEMAY ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-3146
Practice Address - Country:US
Practice Address - Phone:313-473-9573
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service