Holistic Psychiatry | |
4050 E 12 Mile Rd Warren MI 48092-2534 | |
(313) 574-8579 | |
Not Available |
Full Name | Holistic Psychiatry |
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Speciality | Psychiatry & Neurology |
Location | 4050 E 12 Mile Rd, Warren, Michigan |
Authorized Official Name and Position | Bens Sandaire (OWNER) |
Authorized Official Contact | 5865820500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Holistic Psychiatry 680 Bedford Ln Grosse Pointe Park MI 48230-1801 Ph: (313) 574-8579 | Holistic Psychiatry 4050 E 12 Mile Rd Warren MI 48092-2534 Ph: (313) 574-8579 |
NPI Number | 1184395410 |
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Provider Enumeration Date | 09/27/2021 |
Last Update Date | 10/03/2024 |
Certification Date | 10/03/2024 |
Medicare PECOS PAC ID | 8123417532 |
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Medicare Enrollment ID | O20211104003165 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184395410 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Bens J Sandaire |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1417156332 PECOS PAC ID: 2365344751 Enrollment ID: I20081111000132 |
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