Organization · NPI-2

Educating U4 Life Cdc

Community/Behavioral Health · Detroit, MI

NPI number1336674415
StatusActive
Last updated in NPPESJul 25, 2019

Details

NPI
1336674415
Entity type
Organization (NPI-2)
Legal business name
Educating U4 Life Cdc
Organization subpart
No
Enumeration date
Apr 26, 2017
Last updated
Jul 25, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251S00000X Community/Behavioral Health6801011686MIYes
252Y00000X Early Intervention Provider Agency6801046708MI

Practice location

19321 W Chicago St
Detroit, MI 48228-1739

Phone 877-267-3491

Mailing address

22503 Grand River Ave
Suite 19653
Detroit, MI 48219-5034

Phone 877-267-3491

Authorized official

Albert Eugene Mack
Executive Director
8772673491

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