Provider Demographics
NPI:1467009258
Name:JABEZ RECOVERY MANAGEMENT SERVICES
Entity Type:Organization
Organization Name:JABEZ RECOVERY MANAGEMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:ZAKIYA
Authorized Official - Middle Name:LUCAS
Authorized Official - Last Name:ANIAPAM
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW
Authorized Official - Phone:248-935-7722
Mailing Address - Street 1:2755 COLLINGWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48206-1476
Mailing Address - Country:US
Mailing Address - Phone:248-935-7722
Mailing Address - Fax:
Practice Address - Street 1:2755 COLLINGWOOD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48206-1476
Practice Address - Country:US
Practice Address - Phone:248-935-7722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children