| Diversified Behavioral Health Solutions | |
|
309 Mcmorran Blvd Port Huron MI 48060-3807 | |
| (734) 260-0707 | |
| Not Available |
| Full Name | Diversified Behavioral Health Solutions |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 309 Mcmorran Blvd, Port Huron, Michigan |
| Authorized Official Name and Position | Eddia Mcdade (OWNER/ CLINICAL DIRECTOR) |
| Authorized Official Contact | 7342600707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diversified Behavioral Health Solutions 3023 Lindsay Ln Port Huron MI 48060-7780 Ph: (734) 260-0707 | Diversified Behavioral Health Solutions 309 Mcmorran Blvd Port Huron MI 48060-3807 Ph: (734) 260-0707 |
| NPI Number | 1245804244 |
|---|---|
| Provider Enumeration Date | 05/14/2021 |
| Last Update Date | 05/27/2021 |
| Certification Date | 05/27/2021 |
| Medicare PECOS PAC ID | 7517366123 |
|---|---|
| Medicare Enrollment ID | O20210602001974 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245804244 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Secondary |
| Provider Name | Eddia M Mcdade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942685607 PECOS PAC ID: 3375818081 Enrollment ID: I20171005002728 |
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