| Therapy Alliance Of Michigan, Inc. | |
|
36750 Theodore St Clinton Township MI 48035-1955 | |
| (586) 960-5744 | |
| Not Available |
| Full Name | Therapy Alliance Of Michigan, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 36750 Theodore St, Clinton Township, Michigan |
| Authorized Official Name and Position | Amanda J Lilley (OWNER/CEO) |
| Authorized Official Contact | 5869605744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapy Alliance Of Michigan, Inc. Po Box 380991 Clinton Township MI 48038-0074 Ph: (586) 960-5744 | Therapy Alliance Of Michigan, Inc. 36750 Theodore St Clinton Township MI 48035-1955 Ph: (586) 960-5744 |
| NPI Number | 1649863192 |
|---|---|
| Provider Enumeration Date | 02/16/2021 |
| Last Update Date | 02/16/2021 |
| Certification Date | 02/16/2021 |
| Medicare PECOS PAC ID | 2961818133 |
|---|---|
| Medicare Enrollment ID | O20210312001632 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649863192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Amanda Jade Lilley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629452941 PECOS PAC ID: 3870909047 Enrollment ID: I20210312001722 |
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