Opening New Doors Llc | |
17844 Mack Ave Grosse Pointe MI 48230-6234 | |
(248) 417-0248 | |
Not Available |
Full Name | Opening New Doors Llc |
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Speciality | Counselor |
Location | 17844 Mack Ave, Grosse Pointe, Michigan |
Authorized Official Name and Position | Neoshua Butler (CLINICAL DIRECTOR) |
Authorized Official Contact | 2484170248 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Opening New Doors Llc 17844 Mack Ave Grosse Pointe MI 48230-6234 Ph: (248) 417-0248 | Opening New Doors Llc 17844 Mack Ave Grosse Pointe MI 48230-6234 Ph: (248) 417-0248 |
NPI Number | 1144936626 |
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Provider Enumeration Date | 01/27/2023 |
Last Update Date | 05/09/2023 |
Certification Date | 05/09/2023 |
Medicare PECOS PAC ID | 2668831066 |
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Medicare Enrollment ID | O20230703001497 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144936626 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Provider Name | Neoshua Butler |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1699289918 PECOS PAC ID: 5395104798 Enrollment ID: I20230703001636 |
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