Provider Demographics
NPI:1356113856
Name:THE OPEN DOOR CHURCH OF GOD IN CHRIST-DETROIT
Entity type:Organization
Organization Name:THE OPEN DOOR CHURCH OF GOD IN CHRIST-DETROIT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT PASTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:CHW
Authorized Official - Phone:313-526-3460
Mailing Address - Street 1:12411 E 7 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48205-2154
Mailing Address - Country:US
Mailing Address - Phone:313-526-3460
Mailing Address - Fax:313-526-7348
Practice Address - Street 1:12411 E 7 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48205-2154
Practice Address - Country:US
Practice Address - Phone:313-526-3460
Practice Address - Fax:313-526-7348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or Welfare
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No251V00000XAgenciesVoluntary or Charitable
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)