Provider Demographics
NPI:1568233195
Name:DASHONTA D WARREN LLC
Entity Type:Organization
Organization Name:DASHONTA D WARREN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DASHONTA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:SST
Authorized Official - Phone:734-881-7302
Mailing Address - Street 1:3800 GREENFIELD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48120-1206
Mailing Address - Country:US
Mailing Address - Phone:734-881-7302
Mailing Address - Fax:
Practice Address - Street 1:3800 GREENFIELD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1206
Practice Address - Country:US
Practice Address - Phone:313-326-1078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriverGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No174200000XOther Service ProvidersMealsGroup - Multi-Specialty
No177F00000XOther Service ProvidersLodgingGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6803085540OtherSOCIAL SERVICE TECHINICAN