Provider Demographics
NPI:1770658239
Name:DETROIT INSTITUTE FOR CHILDREN
Entity Type:Organization
Organization Name:DETROIT INSTITUTE FOR CHILDREN
Other - Org Name:THE ABILITIES CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-578-4503
Mailing Address - Street 1:5447 WOODWARD AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-4009
Mailing Address - Country:US
Mailing Address - Phone:313-832-1100
Mailing Address - Fax:313-578-4520
Practice Address - Street 1:2075 E WEST MAPLE RD
Practice Address - Street 2:SUITE B-204
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48390-3816
Practice Address - Country:US
Practice Address - Phone:248-926-0909
Practice Address - Fax:313-578-4520
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DETROIT INSTITUTE FOR CHILDREN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-21
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty