| Barry C Eitel, Inc. | |
|
4315 Piehl Rd Ottawa Lake MI 49267-8710 | |
| (419) 260-5552 | |
| Not Available |
| Full Name | Barry C Eitel, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 4315 Piehl Rd, Ottawa Lake, Michigan |
| Authorized Official Name and Position | Barry Eitel (PRESIDENT) |
| Authorized Official Contact | 4192605552 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Barry C Eitel, Inc. 4315 Piehl Rd Ottawa Lake MI 49267-8710 Ph: (419) 260-5552 | Barry C Eitel, Inc. 4315 Piehl Rd Ottawa Lake MI 49267-8710 Ph: (419) 260-5552 |
| NPI Number | 1134250764 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2769663467 |
|---|---|
| Medicare Enrollment ID | O20110301000735 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134250764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Barry Craig Eitel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225066152 PECOS PAC ID: 6204840374 Enrollment ID: I20060127000172 |
Restorative Roots Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 6399 Sylvania Petersburg Rd, Ottawa Lake, MI 49267 Phone: 678-756-9932 |