Provider Demographics
NPI:1215366646
Name:ACCESS
Entity type:Organization
Organization Name:ACCESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAKEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:LUMMUBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-945-8138
Mailing Address - Street 1:6451 SCHAEFER RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2651 SAULINO CT
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48120-1556
Practice Address - Country:US
Practice Address - Phone:313-842-7010
Practice Address - Fax:313-842-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801083912251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health