| Avalon Healing Center | |
|
601 Bagley St Detroit MI 48226-1306 | |
| (313) 964-9701 | |
| Not Available |
| Full Name | Avalon Healing Center |
|---|---|
| Speciality | Counselor |
| Location | 601 Bagley St, Detroit, Michigan |
| Authorized Official Name and Position | Kimberly Hurst (PRESIDENT) |
| Authorized Official Contact | 3139649701 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avalon Healing Center 601 Bagley St Detroit MI 48226-1306 Ph: (313) 964-9701 | Avalon Healing Center 601 Bagley St Detroit MI 48226-1306 Ph: (313) 964-9701 |
| NPI Number | 1073211991 |
|---|---|
| Provider Enumeration Date | 02/20/2023 |
| Last Update Date | 06/12/2023 |
| Certification Date | 06/12/2023 |
| Medicare PECOS PAC ID | 4587026679 |
|---|---|
| Medicare Enrollment ID | O20230822002342 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073211991 | NPI | - | NPPES |
| Provider Name | Michelle Demey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598259103 PECOS PAC ID: 5991167082 Enrollment ID: I20230822002499 |
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