Provider Demographics
NPI:1588020705
Name:METRO COMMUNITY RESOURCES CENTER OF MI
Entity type:Organization
Organization Name:METRO COMMUNITY RESOURCES CENTER OF MI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-897-1761
Mailing Address - Street 1:901 W GRAND BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48208-2353
Mailing Address - Country:US
Mailing Address - Phone:313-457-7870
Mailing Address - Fax:313-897-1772
Practice Address - Street 1:901 W GRAND BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48208-2353
Practice Address - Country:US
Practice Address - Phone:313-457-7870
Practice Address - Fax:313-897-1772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare