| Trinity Health Behavioral Health Muskegon | |
|
125 E Southern Ave Ste 120 Muskegon MI 49442-5041 | |
| (231) 672-4950 | |
| (231) 672-5519 |
| Full Name | Trinity Health Behavioral Health Muskegon |
|---|---|
| Speciality | Clinic/Center |
| Location | 125 E Southern Ave Ste 120, Muskegon, Michigan |
| Authorized Official Name and Position | Daniel Green (VP FINANCE GRAND RAPIDS) |
| Authorized Official Contact | 6166856709 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Health Behavioral Health Muskegon Po Box 776974 Chicago IL 60677-6974 Ph: (800) 494-5797 | Trinity Health Behavioral Health Muskegon 125 E Southern Ave Ste 120 Muskegon MI 49442-5041 Ph: (231) 672-4950 |
| NPI Number | 1194767186 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 10/10/2024 |
| Certification Date | 10/10/2024 |
| Medicare PECOS PAC ID | 5799694949 |
|---|---|
| Medicare Enrollment ID | O20040311000097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194767186 | NPI | - | NPPES |
| 0N85740 | Other | MI | GROUP PTAN |
| 0P15090 | Other | MI | GROUP PTAN |
| 0F16394 | Other | MI | GROUP PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Brian D Krause |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588638068 PECOS PAC ID: 8224183645 Enrollment ID: I20090908000289 |
| Provider Name | Virgilio F Vasquez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376590489 PECOS PAC ID: 2567599517 Enrollment ID: I20100422000568 |
| Provider Name | Peter B Mikhail |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316181308 PECOS PAC ID: 9931362019 Enrollment ID: I20121219000541 |
| Provider Name | Eric E Erickson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558342220 PECOS PAC ID: 9931157120 Enrollment ID: I20140211000643 |
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