Provider Demographics
NPI:1942915269
Name:OAKLAND COUNTY DETOX CENTER , LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:OAKLAND COUNTY DETOX CENTER , LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARJEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-444-2772
Mailing Address - Street 1:4108 KINFOLK CT
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-8203
Mailing Address - Country:US
Mailing Address - Phone:248-444-2772
Mailing Address - Fax:
Practice Address - Street 1:4108 KINFOLK CT
Practice Address - Street 2:
Practice Address - City:PINCKNEY
Practice Address - State:MI
Practice Address - Zip Code:48169-8203
Practice Address - Country:US
Practice Address - Phone:248-444-2772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility