Provider Demographics
NPI:1457621567
Name:SUBSTANCE DETECTION CENTER
Entity Type:Organization
Organization Name:SUBSTANCE DETECTION CENTER
Other - Org Name:SUBSTANCE DETECTION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARTDRELL
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-992-8240
Mailing Address - Street 1:10000 WAYNE ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174
Mailing Address - Country:US
Mailing Address - Phone:734-992-8240
Mailing Address - Fax:734-992-8245
Practice Address - Street 1:10000 WAYNE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-3445
Practice Address - Country:US
Practice Address - Phone:734-992-8240
Practice Address - Fax:734-992-8245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder