| J E Laird 1 Llc | |
|
5265 W Pierson Rd Flushing MI 48433-2461 | |
| (810) 715-9029 | |
| Not Available |
| Full Name | J E Laird 1 Llc |
|---|---|
| Speciality | Counselor |
| Location | 5265 W Pierson Rd, Flushing, Michigan |
| Authorized Official Name and Position | Joseph E Laird (CEO) |
| Authorized Official Contact | 8102107429 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J E Laird 1 Llc 6362 Boulder Dr Flushing MI 48433-3503 Ph: (810) 210-7429 | J E Laird 1 Llc 5265 W Pierson Rd Flushing MI 48433-2461 Ph: (810) 715-9029 |
| NPI Number | 1861035461 |
|---|---|
| Provider Enumeration Date | 10/26/2019 |
| Last Update Date | 04/01/2020 |
| Certification Date | 04/01/2020 |
| Medicare PECOS PAC ID | 0244667673 |
|---|---|
| Medicare Enrollment ID | O20200225001866 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861035461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Diamond C Terry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386207892 PECOS PAC ID: 0446580757 Enrollment ID: I20191001000264 |
| Provider Name | Joseph E Laird |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902192255 PECOS PAC ID: 9133556566 Enrollment ID: I20240308001040 |
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