Provider Demographics
NPI:1184060121
Name:H.O.T.E.P. CHRISTIAN SERVICES INC.
Entity type:Organization
Organization Name:H.O.T.E.P. CHRISTIAN SERVICES INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:URAL
Authorized Official - Middle Name:HEYWOOD
Authorized Official - Last Name:HILL
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:313-659-8424
Mailing Address - Street 1:333 S MAIN ST
Mailing Address - Street 2:202
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2179
Mailing Address - Country:US
Mailing Address - Phone:734-789-7749
Mailing Address - Fax:734-780-7749
Practice Address - Street 1:1100 N MAIN ST
Practice Address - Street 2:109
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-1059
Practice Address - Country:US
Practice Address - Phone:313-659-8424
Practice Address - Fax:734-780-7749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010694131041C0700X
MI53024105961835P0018X
MI6401012466101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1215205885OtherNPI TYPE 1