| Kadima Jewish Support Services For Adults With Mental Illness | |
|
15999 West 12 Mile Road Southfield MI 48382 | |
| (248) 559-8235 | |
| (248) 423-9318 |
| Full Name | Kadima Jewish Support Services For Adults With Mental Illness |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 15999 West 12 Mile Road, Southfield, Michigan |
| Authorized Official Name and Position | Janette Shallal (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2485598235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kadima Jewish Support Services For Adults With Mental Illness 15999 W 12 Mile Rd Southfield MI 48076-7159 Ph: (248) 559-8235 | Kadima Jewish Support Services For Adults With Mental Illness 15999 West 12 Mile Road Southfield MI 48382 Ph: (248) 559-8235 |
| NPI Number | 1184836082 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 08/11/2010 |
| Medicare PECOS PAC ID | 6305851742 |
|---|---|
| Medicare Enrollment ID | O20060207000389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184836082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jean Marie Nemenzik |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578640637 PECOS PAC ID: 3779582929 Enrollment ID: I20061215000416 |
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