| Coventures Llc | |
|
986 S Telegraph Rd Monroe MI 48161-4097 | |
| (734) 770-7573 | |
| Not Available |
| Full Name | Coventures Llc |
|---|---|
| Speciality | Social Worker |
| Location | 986 S Telegraph Rd, Monroe, Michigan |
| Authorized Official Name and Position | Michael Boudrie (CO-OWNER) |
| Authorized Official Contact | 74347707573 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coventures Llc 4328 Cousino La Salle MI 48145-9623 Ph: () - | Coventures Llc 986 S Telegraph Rd Monroe MI 48161-4097 Ph: (734) 770-7573 |
| NPI Number | 1457568784 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 01/13/2015 |
| Medicare PECOS PAC ID | 1850615154 |
|---|---|
| Medicare Enrollment ID | O20150114002325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457568784 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 6801035097 (Michigan) | Primary |
| Provider Name | Michael Edward Boudrie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609860436 PECOS PAC ID: 3274553284 Enrollment ID: I20150114002396 |
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