| Conversion Contracting Llc | |
|
20131 James Couzens Fwy Detroit MI 48235-1890 | |
| (313) 558-8499 | |
| Not Available |
| Full Name | Conversion Contracting Llc |
|---|---|
| Speciality | Counselor |
| Location | 20131 James Couzens Fwy, Detroit, Michigan |
| Authorized Official Name and Position | Amaris Brown (ADMINISTRATOR) |
| Authorized Official Contact | 3134454765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conversion Contracting Llc 20131 James Couzens Fwy Detroit MI 48235-1890 Ph: (313) 558-8499 | Conversion Contracting Llc 20131 James Couzens Fwy Detroit MI 48235-1890 Ph: (313) 558-8499 |
| NPI Number | 1619749801 |
|---|---|
| Provider Enumeration Date | 10/23/2023 |
| Last Update Date | 10/23/2023 |
| Certification Date | 10/23/2023 |
| Medicare PECOS PAC ID | 7315393105 |
|---|---|
| Medicare Enrollment ID | O20231031001476 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619749801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| Provider Name | Raymond Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205016185 PECOS PAC ID: 2769651843 Enrollment ID: I20110805000440 |
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