| Emagine Health Services Llc | |
|
8904 Woodward Ave Detroit MI 48202-1821 | |
| (888) 693-6244 | |
| Not Available |
| Full Name | Emagine Health Services Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 8904 Woodward Ave, Detroit, Michigan |
| Authorized Official Name and Position | Samah Khatib (BCBA) |
| Authorized Official Contact | 3135526630 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emagine Health Services Llc 8904 Woodward Ave Detroit MI 48202-1821 Ph: (888) 693-6244 | Emagine Health Services Llc 8904 Woodward Ave Detroit MI 48202-1821 Ph: (888) 693-6244 |
| NPI Number | 1518685460 |
|---|---|
| Provider Enumeration Date | 08/17/2022 |
| Last Update Date | 11/06/2023 |
| Certification Date | 11/06/2023 |
| Medicare PECOS PAC ID | 9436525284 |
|---|---|
| Medicare Enrollment ID | O20221019000416 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518685460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| Provider Name | Kristin A Felgenauer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962798272 PECOS PAC ID: 2365790102 Enrollment ID: I20180809005650 |
| Provider Name | Yvonne Theresa Davis |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134496581 PECOS PAC ID: 6709249329 Enrollment ID: I20230830002364 |
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