Provider Demographics
NPI:1154717247
Name:OUR PLACE DROP INC
Entity type:Organization
Organization Name:OUR PLACE DROP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NOWACKI
Authorized Official - Suffix:
Authorized Official - Credentials:CPSS
Authorized Official - Phone:313-543-3393
Mailing Address - Street 1:12285 DIXIE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-2491
Mailing Address - Country:US
Mailing Address - Phone:313-543-3393
Mailing Address - Fax:313-543-3395
Practice Address - Street 1:12285 DIXIE
Practice Address - Street 2:SUITE 100
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-2491
Practice Address - Country:US
Practice Address - Phone:313-543-3393
Practice Address - Fax:313-543-3395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-15
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health