| Mending Minds Psychiatric Service Pllc | |
|
3400 Shattuck Rd Ste 2 Saginaw MI 48603-3157 | |
| (989) 928-6616 | |
| Not Available |
| Full Name | Mending Minds Psychiatric Service Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3400 Shattuck Rd Ste 2, Saginaw, Michigan |
| Authorized Official Name and Position | Jennifer Dietzel (OWNER/CEO) |
| Authorized Official Contact | 9899286616 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mending Minds Psychiatric Service Pllc 3400 Shattuck Rd Ste 2 Saginaw MI 48603-3157 Ph: (989) 270-3979 | Mending Minds Psychiatric Service Pllc 3400 Shattuck Rd Ste 2 Saginaw MI 48603-3157 Ph: (989) 928-6616 |
| NPI Number | 1467119339 |
|---|---|
| Provider Enumeration Date | 11/26/2021 |
| Last Update Date | 11/17/2022 |
| Certification Date | 11/17/2022 |
| Medicare PECOS PAC ID | 2062803331 |
|---|---|
| Medicare Enrollment ID | O20211221000309 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467119339 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| Provider Name | Jennifer L Dietzel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376973073 PECOS PAC ID: 5991934838 Enrollment ID: I20140218001970 |
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