| Life Line Psychiatric Services | |
|
25501 Van Dyke Ave Center Line MI 48015-1824 | |
| (586) 755-8911 | |
| Not Available |
| Full Name | Life Line Psychiatric Services |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 25501 Van Dyke Ave, Center Line, Michigan |
| Authorized Official Name and Position | Wladimir Zarski (OWNER) |
| Authorized Official Contact | 5867558911 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Line Psychiatric Services 11456 Meadowbrook Dr Warren MI 48093-6554 Ph: (586) 558-0053 | Life Line Psychiatric Services 25501 Van Dyke Ave Center Line MI 48015-1824 Ph: (586) 755-8911 |
| NPI Number | 1285064063 |
|---|---|
| Provider Enumeration Date | 11/15/2013 |
| Last Update Date | 11/15/2013 |
| Medicare PECOS PAC ID | 8224265319 |
|---|---|
| Medicare Enrollment ID | O20131217001145 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285064063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 4301405636 (Michigan) | Primary |
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