Provider Demographics
NPI:1871865253
Name:AIDS PARTNERSHIP MICHIGAN, INC
Entity Type:Organization
Organization Name:AIDS PARTNERSHIP MICHIGAN, INC
Other - Org Name:WELLNESS NETWORKS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PROGRAM OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MILLBOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:313-446-9811
Mailing Address - Street 1:3011 WEST GRAND BOULEVARD
Mailing Address - Street 2:STE. 230
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3042
Mailing Address - Country:US
Mailing Address - Phone:313-446-9800
Mailing Address - Fax:313-446-9839
Practice Address - Street 1:3011 WEST GRAND BOULEVARD
Practice Address - Street 2:STE. 230
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3042
Practice Address - Country:US
Practice Address - Phone:313-446-9800
Practice Address - Fax:313-446-9839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-01
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010178661041C0700X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty