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711 S. Illinois Avenue Obot Room #100 Gaylord MI 49735-1763 | |
| (989) 732-4357 | |
| (989) 732-4356 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
| Location | 711 S. Illinois Avenue, Gaylord, Michigan |
| Authorized Official Name and Position | Jay Higham (CEO) |
| Authorized Official Contact | 2143656112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5001 Spring Valley Road Suite 600 East Dallas TX 75244-3946 Ph: (214) 365-6100 | 711 S. Illinois Avenue Obot Room #100 Gaylord MI 49735-1763 Ph: (989) 732-4357 |
| NPI Number | 1508571241 |
|---|---|
| Provider Enumeration Date | 01/17/2023 |
| Last Update Date | 12/26/2024 |
| Certification Date | 12/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508571241 | NPI | - | NPPES |
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