Gratiot Clinic

LBN: Gratiot Clinic
Gratiot Clinic is an health care organization with primary practice located at 3506 Gratiot Ave , Detroit MI 48207-1830. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as the primary health care specialty. Gratiot Clinic can be contacted via phone (313) 887-6761, or through Perry, Kenneth Dwayne via phone (313) 887-6760.

Contact Information

Primary practice address
3506 Gratiot Ave Detroit MI 48207-1830
Phone: (313) 887-6761
Fax: (313) 852-4847
Website:
Map and Directions
Authorized official contact:
Name: Perry, Kenneth Dwayne
Phone: (313) 887-6760

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 820522 Michigan

Profile Details

NPI number 1710102249
LBN Legal business name Gratiot Clinic
DBA Doing business as
Authorized official Perry, Kenneth Dwayne
Entity Organization
Organization subpart 1 No
Enumeration date Apr 17th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710102249 NPPES
Michigan Other MI10142 STATE LICENSE

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