| Clinical Healing Center Llc | |
|
2 Crocker Blvd Ste 100 Mount Clemens MI 48043-2558 | |
| (586) 318-4221 | |
| Not Available |
| Full Name | Clinical Healing Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2 Crocker Blvd Ste 100, Mount Clemens, Michigan |
| Authorized Official Name and Position | Timothy Lee Weaver (CLINICIAN) |
| Authorized Official Contact | 5863184221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical Healing Center Llc 35181 Pleasant Farm Rd Richmond MI 48062-4235 Ph: () - | Clinical Healing Center Llc 2 Crocker Blvd Ste 100 Mount Clemens MI 48043-2558 Ph: (586) 318-4221 |
| NPI Number | 1790477099 |
|---|---|
| Provider Enumeration Date | 05/24/2023 |
| Last Update Date | 12/15/2023 |
| Certification Date | 12/15/2023 |
| Medicare PECOS PAC ID | 9537516729 |
|---|---|
| Medicare Enrollment ID | O20231221003678 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790477099 | NPI | - | NPPES |
| Provider Name | Timothy L Weaver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730635731 PECOS PAC ID: 3779907753 Enrollment ID: I20200622001808 |
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