| Health Centers Detroit Foundation, Inc. | |
|
4201 Saint Antoine St 7a Detroit MI 48201-2153 | |
| (313) 745-4091 | |
| (313) 966-0993 |
| Full Name | Health Centers Detroit Foundation, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 4201 Saint Antoine St, Detroit, Michigan |
| Authorized Official Name and Position | Herbert C. Smitherman (PRESIDENT & CEO) |
| Authorized Official Contact | 3139665187 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Centers Detroit Foundation, Inc. 4201 Saint Antoine St 9d Detroit MI 48201-2153 Ph: (313) 966-5187 | Health Centers Detroit Foundation, Inc. 4201 Saint Antoine St 7a Detroit MI 48201-2153 Ph: (313) 745-4091 |
| NPI Number | 1770657785 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 01/20/2012 |
| Medicare PECOS PAC ID | 4284539081 |
|---|---|
| Medicare Enrollment ID | O20230126002440 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770657785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 443750 (Michigan) | Primary |
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