| Recovery Mobile Clinic | |
|
4706 Product Dr Ste 1 Wixom MI 48393-2071 | |
| (248) 567-2334 | |
| Not Available |
| Full Name | Recovery Mobile Clinic |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4706 Product Dr Ste 1, Wixom, Michigan |
| Authorized Official Name and Position | Jordana Leanne Latozas (CEO/OWNER) |
| Authorized Official Contact | 2485635735 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Recovery Mobile Clinic 7111 Dixie Hwy # 142 Clarkston MI 48346-2077 Ph: (248) 563-5735 | Recovery Mobile Clinic 4706 Product Dr Ste 1 Wixom MI 48393-2071 Ph: (248) 567-2334 |
| NPI Number | 1902431653 |
|---|---|
| Provider Enumeration Date | 03/03/2020 |
| Last Update Date | 12/03/2025 |
| Medicare PECOS PAC ID | 9032532528 |
|---|---|
| Medicare Enrollment ID | O20200630002084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902431653 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | (* (Not Available)) | Primary |
| Provider Name | Jordana L Latozas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831492123 PECOS PAC ID: 6305010588 Enrollment ID: I20111128000544 |
| Provider Name | Ian Alexander Wolffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790306405 PECOS PAC ID: 6709288905 Enrollment ID: I20210712000172 |
| Provider Name | Jamie L Rates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992326946 PECOS PAC ID: 9537565593 Enrollment ID: I20210831002108 |
| Provider Name | Mallory Deel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790382463 PECOS PAC ID: 3870981574 Enrollment ID: I20211029001164 |
| Provider Name | Alexis Skuras |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1154003119 PECOS PAC ID: 0749636181 Enrollment ID: I20231021000361 |
| Provider Name | Kathryn Mclean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962957845 PECOS PAC ID: 1951754506 Enrollment ID: I20240130003032 |
| Provider Name | Tara Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841065760 PECOS PAC ID: 2365980828 Enrollment ID: I20240814004271 |
Responsive Visiting Physicians Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 49175 West Rd, Wixom, MI 48393 Phone: 248-487-8686 Fax: 248-694-2113 | |
Papnez Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1545 N Wixom Rd, Wixom, MI 48393 Phone: 248-833-6343 Fax: 248-833-6343 | |
Trinity Medical Consultants Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 49175 West Rd, Wixom, MI 48393 Phone: 248-487-8686 |