Mariners Inn in Detroit - Community Based Residential Treatment Facility, Mental Illness
Mariners Inn - NPI 1558485466
Mariners Inn is a Community Based Residential Treatment Facility, Mental Illness in Detroit, Michigan. Mariners Inn practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Mental Illness. The NPI Number for Mariners Inn is 1558485466. The last update date is 2018-04-20.
Mariners Inn's current location address is 445 Ledyard St, Detroit, Michigan. You can contact this provider via phone number 3139629446 and fax number 3139626395. The mailing address for Mariners Inn is 445 Ledyard St, Detroit, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Mariners Inn |
|---|---|
| Address | 445 Ledyard St, Detroit, Michigan |
| Phone Number | 3139629446 |
| Fax Number | 3139626395 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CHIEF EXEC |
|---|---|
| Authorized Official Name | Sampson David |
| Credentials | LMSW |
| Telephone Number | 3139629446 |
NPI Number Detail
| NPI Number | 1558485466 |
|---|---|
| Provider Enumeration Date | 2007-03-17 |
| Last Updated Date | 2018-04-20 |
Provider Mailing Address Detail
| Address | 445 Ledyard St |
|---|---|
| City | Detroit |
| State | Michigan (MI) |
| Post Code | 482012641 |
| Phone Number | 3139629446 |
| Fax Number | 3139626395 |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Mental Illness |
|---|---|
| Taxonomy | 320800000X |
| Licence No | SA820152 |
|
Definition: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 56421819 | MI | TPIN ASSIGNMENT |
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What is the unique identifier code issued to Mariners Inn by the Centers for Medicare & Medicaid Services?
The Mariners Inn has been assigned the NPI (National Provider Identifier) 1558485466. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Mariners Inn is located?
The Mariners Inn is situated at the following address: 445 Ledyard St, Detroit, MI, 482012641.
What is Mariners Inn's area of expertise and its corresponding taxonomy classification?
The Mariners Inn's field of specialization is Community Based Residential Treatment Facility, Mental Illness, and it falls under the taxonomy code 320800000X, which categorizes healthcare providers based on their areas of practice.
When was the Mariners Inn's 1558485466 issued?
The Mariners Inn's 1558485466 was issued on 2007-03-17.
As of what date were the details related to Mariners Inn most recently updated or revised?
The information pertaining to Mariners Inn, including its address, specialty, and other relevant details, was last updated or revised on 2018-04-20.