1063561660 NPI number — DEAF,HEARING, AND SIGN LANGUAGE CENTER INC.

Table of content: (NPI 1063561660)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063561660 NPI number — DEAF,HEARING, AND SIGN LANGUAGE CENTER INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEAF,HEARING, AND SIGN LANGUAGE CENTER INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063561660
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19185 WYOMING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DETROIT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48221-3219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
313-341-1353
Provider Business Mailing Address Fax Number:
313-341-4091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19185 WYOMING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DETROIT
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48221-3219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
313-341-1353
Provider Business Practice Location Address Fax Number:
313-341-4091
Provider Enumeration Date:
01/10/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WOODSON
Authorized Official First Name:
MONICA
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
E.D.
Authorized Official Telephone Number:
313-341-1353

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  3501002615 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 235Z00000X , with the licence number: 12074769 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 237600000X , with the licence number: 3501002615 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4747845 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4728607 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".