| Majestical Group | |
|
20764 Knob Woods Dr Southfield MI 48076-4014 | |
| (313) 999-0892 | |
| Not Available |
| Full Name | Majestical Group |
|---|---|
| Speciality | Social Worker |
| Location | 20764 Knob Woods Dr, Southfield, Michigan |
| Authorized Official Name and Position | Victoria Lynn Palmer (ADMINISTRATOR) |
| Authorized Official Contact | 3139990892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Majestical Group 20764 Knob Woods Dr Southfield MI 48076-4014 Ph: (313) 999-0892 | Majestical Group 20764 Knob Woods Dr Southfield MI 48076-4014 Ph: (313) 999-0892 |
| NPI Number | 1518521806 |
|---|---|
| Provider Enumeration Date | 04/23/2019 |
| Last Update Date | 06/09/2021 |
| Certification Date | 06/09/2021 |
| Medicare PECOS PAC ID | 2466795232 |
|---|---|
| Medicare Enrollment ID | O20190517001013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518521806 | NPI | - | NPPES |
| Provider Name | Allen R Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013175587 PECOS PAC ID: 9537226295 Enrollment ID: I20090324000489 |
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