Provider Demographics
NPI:1427417476
Name:TRUE TESTING ALCOHOL & DRUG LLC
Entity Type:Organization
Organization Name:TRUE TESTING ALCOHOL & DRUG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:MA/LBSW/LLPC
Authorized Official - Phone:313-279-0460
Mailing Address - Street 1:13310 W MCNICHOLS RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-4121
Mailing Address - Country:US
Mailing Address - Phone:313-279-0460
Mailing Address - Fax:313-279-0463
Practice Address - Street 1:13310 W MCNICHOLS RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-4121
Practice Address - Country:US
Practice Address - Phone:313-279-0460
Practice Address - Fax:313-279-0463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401011475101YP2500X
MI6802079555104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty