Provider Demographics
NPI:1881365831
Name:TOMMIEINC
Entity type:Organization
Organization Name:TOMMIEINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:WATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-748-2500
Mailing Address - Street 1:24801 5 MILE RD STE 26
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-3653
Mailing Address - Country:US
Mailing Address - Phone:313-748-2500
Mailing Address - Fax:586-238-0301
Practice Address - Street 1:20184 WARD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-1141
Practice Address - Country:US
Practice Address - Phone:313-862-3519
Practice Address - Fax:313-861-9964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health