| Lake Huron Center Llc | |
|
2870 E Grand Blvd Ste 600 Detroit MI 48202-3120 | |
| (313) 736-5041 | |
| Not Available |
| Full Name | Lake Huron Center Llc |
|---|---|
| Speciality | Counselor |
| Location | 2870 E Grand Blvd Ste 600, Detroit, Michigan |
| Authorized Official Name and Position | Jerrolynn Justusson (PRESIDENT) |
| Authorized Official Contact | 8007430396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Huron Center Llc 2870 E Grand Blvd Ste 600 Detroit MI 48202-3120 Ph: (313) 736-5041 | Lake Huron Center Llc 2870 E Grand Blvd Ste 600 Detroit MI 48202-3120 Ph: (313) 736-5041 |
| NPI Number | 1699543777 |
|---|---|
| Provider Enumeration Date | 12/18/2023 |
| Last Update Date | 12/18/2023 |
| Certification Date | 12/18/2023 |
| Medicare PECOS PAC ID | 0840635249 |
|---|---|
| Medicare Enrollment ID | O20240226000841 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699543777 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| Provider Name | Padgett D Vanhoutteghem |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679622633 PECOS PAC ID: 6103940507 Enrollment ID: I20100909001229 |
| Provider Name | Shanti Turner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265955538 PECOS PAC ID: 9537504931 Enrollment ID: I20240226000678 |
Bjc Counseling And Behavioral Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 16175 Asbury Park, Detroit, MI 48235 Phone: 313-673-1992 | |
Center For Establishing Recovery Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Riverfront Dr Apt 2610, Detroit, MI 48226 Phone: 313-288-2689 | |
Urban Unity Cdc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 12400 E 7 Mile Rd, Detroit, MI 48205 Phone: 313-444-3990 | |
Community Social Services Of Wayne County Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9851 Hamilton Ave, Detroit, MI 48202 Phone: 313-883-2339 Fax: 313-883-3957 | |
Emanuel T. Vanbolden, Phd, Lp, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 60 Farnsworth St, Detroit, MI 48202 Phone: 313-577-2840 Fax: 313-577-8949 | |
Mindful Synergy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3011 W Grand Blvd Ste 1507, Detroit, MI 48202 Phone: 313-608-9512 Fax: 313-462-4829 | |
Embody Her Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1420 Washington Blvd Ste 301, Detroit, MI 48226 Phone: 248-259-2562 |