| Personal Choice Planned Change | |
|
4432 Knightsbridge Ln West Bloomfield MI 48323-1627 | |
| (313) 363-1976 | |
| Not Available |
| Full Name | Personal Choice Planned Change |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4432 Knightsbridge Ln, West Bloomfield, Michigan |
| Authorized Official Name and Position | Roslyn Jo Carter (CEO/DIRECTOR) |
| Authorized Official Contact | 3133631976 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Personal Choice Planned Change 4432 Knightsbridge Ln West Bloomfield MI 48323-1627 Ph: (313) 363-1976 | Personal Choice Planned Change 4432 Knightsbridge Ln West Bloomfield MI 48323-1627 Ph: (313) 363-1976 |
| NPI Number | 1619256799 |
|---|---|
| Provider Enumeration Date | 08/08/2011 |
| Last Update Date | 11/13/2023 |
| Certification Date | 11/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619256799 | NPI | - | NPPES |
| 1164502431 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | 6401004803 (Michigan) | Primary |
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