| Michigan Diagnostic Alcohol And Drug Services Llc | |
|
2449 E 12 Mile Rd Warren MI 48092-5647 | |
| (586) 510-4992 | |
| (586) 393-5012 |
| Full Name | Michigan Diagnostic Alcohol And Drug Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 2449 E 12 Mile Rd, Warren, Michigan |
| Authorized Official Name and Position | Kumar Giri (OWNER) |
| Authorized Official Contact | 5869437390 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michigan Diagnostic Alcohol And Drug Services Llc 2449 E 12 Mile Rd Warren MI 48092-5647 Ph: (586) 510-4992 | Michigan Diagnostic Alcohol And Drug Services Llc 2449 E 12 Mile Rd Warren MI 48092-5647 Ph: (586) 510-4992 |
| NPI Number | 1659729507 |
|---|---|
| Provider Enumeration Date | 06/01/2016 |
| Last Update Date | 08/17/2016 |
| Medicare PECOS PAC ID | 8921386509 |
|---|---|
| Medicare Enrollment ID | O20161102001350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659729507 | NPI | - | NPPES |
| Provider Name | Michael Paul Harbson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902842339 PECOS PAC ID: 4587619655 Enrollment ID: I20050322000487 |
| Provider Name | Marya J Drygalski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366456600 PECOS PAC ID: 8426072406 Enrollment ID: I20060117000954 |
| Provider Name | Kathleen A Allin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013085984 PECOS PAC ID: 6002918331 Enrollment ID: I20070216000411 |
| Provider Name | Marisa C Olafsson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639280068 PECOS PAC ID: 3870668593 Enrollment ID: I20080814000679 |
| Provider Name | April Ceno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568766475 PECOS PAC ID: 1850696972 Enrollment ID: I20160226000648 |
| Provider Name | Carl A Catanese |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629395777 PECOS PAC ID: 6800185760 Enrollment ID: I20160516001664 |
| Provider Name | Gayle J Hatfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942416821 PECOS PAC ID: 4688962301 Enrollment ID: I20161013000299 |
| Provider Name | Amanda Louise Stamm |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588826556 PECOS PAC ID: 4082992573 Enrollment ID: I20161104000129 |
| Provider Name | Raymond Edward Hagermann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801248760 PECOS PAC ID: 4981010683 Enrollment ID: I20210303003308 |
| Provider Name | Nathan Lloyd White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306320627 PECOS PAC ID: 1456769769 Enrollment ID: I20210426000821 |
| Provider Name | Israil Steen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487127056 PECOS PAC ID: 6709264922 Enrollment ID: I20220531002296 |
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