Provider Demographics
NPI:1881135671
Name:ALTRUISTIC COLLECTIVE EXPERIENCE LLC
Entity type:Organization
Organization Name:ALTRUISTIC COLLECTIVE EXPERIENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LENIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-915-0315
Mailing Address - Street 1:PO BOX 21758
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-0758
Mailing Address - Country:US
Mailing Address - Phone:313-915-0315
Mailing Address - Fax:
Practice Address - Street 1:7177 MILLER DR
Practice Address - Street 2:SUITE C
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-1699
Practice Address - Country:US
Practice Address - Phone:313-334-9401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-14
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty