| |
29201 Telegraph Rd Suite 550 Southfield MI 48034-1331 | |
(248) 213-0501 | |
(248) 213-0521 |
Full Name | |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 29201 Telegraph Rd, Southfield, Michigan |
Authorized Official Name and Position | Patricia F Beach (PROVIDER RELATIONS) |
Authorized Official Contact | 2482130501 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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20600 Eureka Rd Suite 819 Taylor MI 48180-5343 Ph: (734) 285-2828 | 29201 Telegraph Rd Suite 550 Southfield MI 48034-1331 Ph: (248) 213-0501 |
NPI Number | 1346378981 |
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Provider Enumeration Date | 03/02/2007 |
Last Update Date | 07/19/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1346378981 | NPI | - | NPPES |
511213 | Other | MI | CARE CHOICES |
BM820042 | Other | MI | MCARE |
101039 | Other | MI | VALUE OPTIONS |
90197000 | Other | MI | MAGELLAN STATE OF MI |
4449395 | Other | MI | AETNA |
7509108970 | Other | MI | BCBS |
004241F3 | Other | MI | HAP |
4441728 | Other | MI | TEAMSTERS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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