Provider Demographics
NPI:1609350677
Name:THE DEMARCO PROJECT
Entity Type:Organization
Organization Name:THE DEMARCO PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESDIENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-322-0397
Mailing Address - Street 1:1830 ROCHESTER RD APT 105
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-4100
Mailing Address - Country:US
Mailing Address - Phone:586-322-6969
Mailing Address - Fax:
Practice Address - Street 1:100 RIVERFRONT DR FL 3
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-4500
Practice Address - Country:US
Practice Address - Phone:586-322-6969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management