| Chaldean Community Foundation | |
|
3601 15 Mile Rd Sterling Heights MI 48310-5356 | |
| (586) 722-7253 | |
| (586) 722-7257 |
| Full Name | Chaldean Community Foundation |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3601 15 Mile Rd, Sterling Heights, Michigan |
| Authorized Official Name and Position | Paul Jonna (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 5867227253 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chaldean Community Foundation 3601 15 Mile Rd Sterling Heights MI 48310-5356 Ph: (586) 722-7253 | Chaldean Community Foundation 3601 15 Mile Rd Sterling Heights MI 48310-5356 Ph: (586) 722-7253 |
| NPI Number | 1669935557 |
|---|---|
| Provider Enumeration Date | 04/09/2019 |
| Last Update Date | 01/21/2021 |
| Certification Date | 01/21/2021 |
| Medicare PECOS PAC ID | 1456779008 |
|---|---|
| Medicare Enrollment ID | O20200914001269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669935557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jacqueline Raxter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134345176 PECOS PAC ID: 0143646067 Enrollment ID: I20200821001439 |
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