Provider Demographics
NPI:1730256496
Name:CYPRIAN CENTER INC.
Entity type:Organization
Organization Name:CYPRIAN CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARQUIERITE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SABA
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, ACSW
Authorized Official - Phone:313-831-3306
Mailing Address - Street 1:4901 CHRYSLER DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-1462
Mailing Address - Country:US
Mailing Address - Phone:313-831-3306
Mailing Address - Fax:313-832-6548
Practice Address - Street 1:4901 CHRYSLER DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-1462
Practice Address - Country:US
Practice Address - Phone:313-831-3306
Practice Address - Fax:313-832-6548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities