| |
1001 Military Street Port Huron MI 48060 | |
(810) 985-5437 | |
(800) 248-1568 |
Full Name | |
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Speciality | Counselor |
Location | 1001 Military Street, Port Huron, Michigan |
Authorized Official Name and Position | Herbert M. Wendt (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8109855437 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1001 Military Street Port Huron MI 48060 Ph: (810) 985-5437 | 1001 Military Street Port Huron MI 48060 Ph: (810) 985-5437 |
NPI Number | 1316059850 |
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Provider Enumeration Date | 08/31/2006 |
Last Update Date | 02/15/2018 |
Medicare PECOS PAC ID | 8921064734 |
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Medicare Enrollment ID | O20041203000351 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316059850 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |
251K00000X | Public Health Or Welfare | (* (Not Available)) | Secondary |
Provider Name | Mohammad Saeed |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1104939719 PECOS PAC ID: 9830084136 Enrollment ID: I20040217000049 |
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