| Center For Peace And Holistic Healing, Llc | |
|
26657 W Carnegie Park Dr Southfield MI 48034-6161 | |
| (248) 703-3990 | |
| (248) 327-6943 |
| Full Name | Center For Peace And Holistic Healing, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 26657 W Carnegie Park Dr, Southfield, Michigan |
| Authorized Official Name and Position | Lillian O. Brown (OWNER) |
| Authorized Official Contact | 2487033990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Peace And Holistic Healing, Llc 26657 W Carnegie Park Dr Southfield MI 48034-6161 Ph: (248) 703-3990 | Center For Peace And Holistic Healing, Llc 26657 W Carnegie Park Dr Southfield MI 48034-6161 Ph: (248) 703-3990 |
| NPI Number | 1689936270 |
|---|---|
| Provider Enumeration Date | 06/11/2012 |
| Last Update Date | 06/11/2012 |
| Medicare PECOS PAC ID | 6608032982 |
|---|---|
| Medicare Enrollment ID | O20120801000252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689936270 | NPI | - | NPPES |
| MI 2757 | Other | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801057321 (Michigan) | Primary |
| Provider Name | Lillian Ojetta Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710187745 PECOS PAC ID: 8123196565 Enrollment ID: I20081013000027 |
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