Provider Demographics
NPI:1871881268
Name:BROADENS HELPING HANDS
Entity type:Organization
Organization Name:BROADENS HELPING HANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEIDRA
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:BROADEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-421-9901
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-0066
Mailing Address - Country:US
Mailing Address - Phone:313-421-9901
Mailing Address - Fax:313-383-3689
Practice Address - Street 1:2236 HUBBELL ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48128-1395
Practice Address - Country:US
Practice Address - Phone:313-421-9901
Practice Address - Fax:313-383-3689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101Y00000X, 101YA0400X, 101YP2500X, 171M00000X, 172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty