Organization · Type 2 NPI

Detroit Community Health Connection, Inc

Federally Qualified Health Center (FQHC) · Detroit, MI

NPI number 1790948982 Active

Practice location

611 Martin Luther King Jr Blvd
Detroit, MI 48201-2273

Call (313) 832-6300 Map

Fax (313) 832-8341

Mailing address

13901 E Jefferson Ave
Detroit, MI 48215-2720

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

4 other providers at this address

Cedrick D. Harrell, CHWCommunity Health Worker Detroit, MI NPI 1477362101
Christopher Lee Laster, CHWCommunity Health Worker Detroit, MI NPI 1649164757
Lavetta Annette Pickens, NURSE PRACTITIONERPrimary Care Nurse Practitioner Detroit, MI NPI 1295073773
Ronaldo B. Supena, MDInfectious Disease Physician Detroit, MI NPI 1275576886

Other federally qualified health center (fqhc) providers in Detroit

See all in Detroit →

NPI record

NPI: 1790948982
Entity type: Organization (Type 2)
Issued: Jul 8, 2008
Last updated: Apr 27, 2013
Status: Active
Subpart: Yes of Detroit Community Health Connection, Inc.

Other names

<unavail>
Woodward Corridor Family Medical Center · doing business as

Authorized official

Mr. Mahipal Rao Kakarala
Srvp/cfo
(313) 821-2591

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1790948982

Detroit Community Health Connection, Inc's National Provider Identifier is 1790948982, issued on Jul 8, 2008. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Detroit, MI. The record was last updated on Apr 27, 2013.