Kalamazoo Tms & Behavioral Health | |
5390 Lovers Ln Third Floor Portage MI 49002 | |
(269) 381-6950 | |
(269) 381-6954 |
Full Name | Kalamazoo Tms & Behavioral Health |
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Speciality | Psychiatry & Neurology |
Location | 5390 Lovers Ln, Portage, Michigan |
Authorized Official Name and Position | Ruqiya Tareen (MEDICAL DIRECTOR) |
Authorized Official Contact | 2693816950 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Kalamazoo Tms & Behavioral Health 5930 Lovers Ln Third Floor Portage MI 49002-1673 Ph: (269) 381-6950 | Kalamazoo Tms & Behavioral Health 5390 Lovers Ln Third Floor Portage MI 49002 Ph: (269) 381-6950 |
NPI Number | 1114219227 |
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Provider Enumeration Date | 05/07/2011 |
Last Update Date | 02/16/2016 |
Medicare PECOS PAC ID | 7911175948 |
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Medicare Enrollment ID | O20110719000359 |
Identifier | Type | State | Issuer |
---|---|---|---|
1114219227 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 4301078095 (Michigan) | Primary |
Provider Name | Ruqiya Tareen |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1598724122 PECOS PAC ID: 5092742239 Enrollment ID: I20050720000240 |
Provider Name | Pamela M Bryant |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669744660 PECOS PAC ID: 5193986099 Enrollment ID: I20120420000353 |
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