| Centria Healthcare - Dearborn Center | |
|
19855 Outer Dr Suite 101 Dearborn MI 48124-2022 | |
| (248) 299-0030 | |
| Not Available |
| Full Name | Centria Healthcare - Dearborn Center |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 19855 Outer Dr, Dearborn, Michigan |
| Authorized Official Name and Position | Christopher Wilcox (PRESIDENT) |
| Authorized Official Contact | 2482990030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centria Healthcare - Dearborn Center 41521 W 11 Mile Rd Novi MI 48375-1803 Ph: (248) 299-0030 | Centria Healthcare - Dearborn Center 19855 Outer Dr Suite 101 Dearborn MI 48124-2022 Ph: (248) 299-0030 |
| NPI Number | 1730586710 |
|---|---|
| Provider Enumeration Date | 11/19/2014 |
| Last Update Date | 12/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730586710 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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