| Centro Latino Department | |
|
1685 Baldwin Ave Ste A Pontiac MI 48340-1242 | |
| (248) 706-3450 | |
| (248) 706-3455 |
| Full Name | Centro Latino Department |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1685 Baldwin Ave Ste A, Pontiac, Michigan |
| Authorized Official Name and Position | Brent Wirth (PRESIDENT & CEO) |
| Authorized Official Contact | 2484756400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Centro Latino Department 2399 E Walton Blvd Auburn Hills MI 48326-1955 Ph: (248) 475-6400 | Centro Latino Department 1685 Baldwin Ave Ste A Pontiac MI 48340-1242 Ph: (248) 706-3450 |
| NPI Number | 1629235924 |
|---|---|
| Provider Enumeration Date | 05/22/2008 |
| Last Update Date | 10/01/2024 |
| Certification Date | 09/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629235924 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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