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6900 E 10 Mile Rd Center Line MI 48015-1168 | |
| (586) 501-3070 | |
| (586) 501-3079 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6900 E 10 Mile Rd, Center Line, Michigan |
| Authorized Official Name and Position | Brent Wirth (CEO/PRESIDENT) |
| Authorized Official Contact | 2484756400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2399 E Walton Blvd Auburn Hills MI 48326-1955 Ph: (248) 475-6400 | 6900 E 10 Mile Rd Center Line MI 48015-1168 Ph: (586) 501-3070 |
| NPI Number | 1588915789 |
|---|---|
| Provider Enumeration Date | 09/27/2012 |
| Last Update Date | 10/01/2024 |
| Certification Date | 09/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588915789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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