Provider Demographics
NPI:1467743245
Name:ABAYOMI COMMUNITY DEVELOPMENT CORPORATION
Entity Type:Organization
Organization Name:ABAYOMI COMMUNITY DEVELOPMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAWNYA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MHSA
Authorized Official - Phone:313-541-9828
Mailing Address - Street 1:24331 W 8 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48219-1028
Mailing Address - Country:US
Mailing Address - Phone:313-541-9828
Mailing Address - Fax:313-541-3820
Practice Address - Street 1:24331 W 8 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-1028
Practice Address - Country:US
Practice Address - Phone:313-541-9828
Practice Address - Fax:313-541-3820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI823071251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management