Provider Demographics
NPI:1457478208
Name:METRO EAST DRUG TREATMENT
Entity Type:Organization
Organization Name:METRO EAST DRUG TREATMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TARONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-371-0055
Mailing Address - Street 1:1251 ELIJAH MCCOY DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3319
Mailing Address - Country:US
Mailing Address - Phone:313-371-0055
Mailing Address - Fax:313-371-1409
Practice Address - Street 1:1251 ELIJAH MCCOY DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3319
Practice Address - Country:US
Practice Address - Phone:313-371-0055
Practice Address - Fax:313-371-1409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI821237101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty