Provider Demographics
NPI:1528191541
Name:HEALTH SERVICES TECHNICAL ASSISTANCE ADDICTION TREATMENT SERVICES
Entity Type:Organization
Organization Name:HEALTH SERVICES TECHNICAL ASSISTANCE ADDICTION TREATMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHESLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-876-4066
Mailing Address - Street 1:1151 TAYLOR ST
Mailing Address - Street 2:BUILDING # 1
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-1732
Mailing Address - Country:US
Mailing Address - Phone:313-870-1920
Mailing Address - Fax:313-870-1992
Practice Address - Street 1:1151 TAYLOR ST
Practice Address - Street 2:BUILDING # 1
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-1732
Practice Address - Country:US
Practice Address - Phone:313-870-1920
Practice Address - Fax:313-870-1992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI821198251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health