Provider Demographics
NPI:1679827216
Name:POSITIVE IMAGES, INC.
Entity Type:Organization
Organization Name:POSITIVE IMAGES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MAISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KENYATTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-822-6940
Mailing Address - Street 1:13336 E WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48215-2112
Mailing Address - Country:US
Mailing Address - Phone:313-822-6940
Mailing Address - Fax:313-822-1157
Practice Address - Street 1:13336 E WARREN AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48215-2112
Practice Address - Country:US
Practice Address - Phone:313-822-6940
Practice Address - Fax:313-822-1157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health