| Easter Seals-michigan, Inc | |
|
5111 Auto Club Dr Dearborn MI 48126-2749 | |
| (248) 536-5085 | |
| (248) 536-5086 |
| Full Name | Easter Seals-michigan, Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5111 Auto Club Dr, Dearborn, Michigan |
| Authorized Official Name and Position | Brent Wirth (PRESIDENT & CEO) |
| Authorized Official Contact | 2484756300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Easter Seals-michigan, Inc 2399 E Walton Blvd Auburn Hills MI 48326-1955 Ph: (248) 475-6300 | Easter Seals-michigan, Inc 5111 Auto Club Dr Dearborn MI 48126-2749 Ph: (248) 536-5085 |
| NPI Number | 1679218739 |
|---|---|
| Provider Enumeration Date | 05/03/2022 |
| Last Update Date | 10/01/2024 |
| Certification Date | 09/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679218739 | NPI | - | NPPES |
| 1023199965 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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