Provider Demographics
NPI:1467862409
Name:INSIGHT AND INTERVENTION
Entity Type:Organization
Organization Name:INSIGHT AND INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-595-6725
Mailing Address - Street 1:12071 ROBSON ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48227-2437
Mailing Address - Country:US
Mailing Address - Phone:313-595-6725
Mailing Address - Fax:313-397-3458
Practice Address - Street 1:12071 ROBSON ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48227-2437
Practice Address - Country:US
Practice Address - Phone:313-595-6725
Practice Address - Fax:313-397-3458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801085593251B00000X
251S00000X
MI680185593324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1831375658OtherNPI