| Emerging Path Llc | |
|
1576 Peck St Muskegon MI 49441-2547 | |
| (231) 727-2901 | |
| Not Available |
| Full Name | Emerging Path Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1576 Peck St, Muskegon, Michigan |
| Authorized Official Name and Position | Diane L Wiegand (OWNER) |
| Authorized Official Contact | 2317272901 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerging Path Llc 1576 Peck St Muskegon MI 49441-2547 Ph: (231) 727-2901 | Emerging Path Llc 1576 Peck St Muskegon MI 49441-2547 Ph: (231) 727-2901 |
| NPI Number | 1619244969 |
|---|---|
| Provider Enumeration Date | 11/30/2011 |
| Last Update Date | 11/30/2011 |
| Medicare PECOS PAC ID | 2961679188 |
|---|---|
| Medicare Enrollment ID | O20120111000499 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619244969 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 6801080675 (Michigan) | Primary |
| Provider Name | Diane L Wiegand |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447384599 PECOS PAC ID: 7012969744 Enrollment ID: I20050210000650 |
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