Provider Demographics
NPI:1477865137
Name:MHGRIFFIN INTERNATIONAL ENTERPRISES, LLC
Entity type:Organization
Organization Name:MHGRIFFIN INTERNATIONAL ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRELL GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CFC, CDVC-II
Authorized Official - Phone:313-835-1800
Mailing Address - Street 1:24801 5 MILE RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-3655
Mailing Address - Country:US
Mailing Address - Phone:313-835-1800
Mailing Address - Fax:313-835-1811
Practice Address - Street 1:24801 5 MILE RD
Practice Address - Street 2:SUITE 14
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3655
Practice Address - Country:US
Practice Address - Phone:313-835-1800
Practice Address - Fax:313-835-1811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802006876261QM1300X, 104100000X
MI6801065631305R00000X, 251B00000X, 1041C0700X
INA21556251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No305R00000XManaged Care OrganizationsPreferred Provider OrganizationGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health