Provider Demographics
NPI:1134782758
Name:ANNIE BELL CHAMBERS MULTI SERVICE CENTER
Entity type:Organization
Organization Name:ANNIE BELL CHAMBERS MULTI SERVICE CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOLSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-362-8122
Mailing Address - Street 1:18400 E 9 MILE RD
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-1962
Mailing Address - Country:US
Mailing Address - Phone:586-362-8122
Mailing Address - Fax:586-362-8126
Practice Address - Street 1:18400 E 9 MILE RD
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-1962
Practice Address - Country:US
Practice Address - Phone:586-362-8122
Practice Address - Fax:586-362-8126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI46Medicaid
MI22Medicaid
MI54Medicaid