| Imagine Center Llc | |
|
100 Maincentre Ste. 16 Northville MI 48167-1578 | |
| (313) 354-3920 | |
| (313) 656-4052 |
| Full Name | Imagine Center Llc |
|---|---|
| Speciality | Psychologist |
| Location | 100 Maincentre, Northville, Michigan |
| Authorized Official Name and Position | Michael Edward Behen (CLINICAL PSYCHOLOGIST/DIRECTOR) |
| Authorized Official Contact | 3133543920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Imagine Center Llc 100 Maincentre Ste. 16 Northville MI 48167-1578 Ph: (313) 354-3920 | Imagine Center Llc 100 Maincentre Ste. 16 Northville MI 48167-1578 Ph: (313) 354-3920 |
| NPI Number | 1467899666 |
|---|---|
| Provider Enumeration Date | 05/29/2013 |
| Last Update Date | 05/29/2013 |
| Medicare PECOS PAC ID | 6507167624 |
|---|---|
| Medicare Enrollment ID | O20151215001703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467899666 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 6301013057 (Michigan) | Primary |
| Provider Name | Michael E Behen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760407696 PECOS PAC ID: 5496845554 Enrollment ID: I20090120000125 |
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