| Mental Health Clinic | |
|
1514 W Milham Ave Portage MI 49024-1296 | |
| (269) 342-0606 | |
| (269) 342-0919 |
| Full Name | Mental Health Clinic |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1514 W Milham Ave, Portage, Michigan |
| Authorized Official Name and Position | Ravinder P Mediratta (OWNER) |
| Authorized Official Contact | 2693420606 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Clinic 1514 W Milham Ave Portage MI 49024-1296 Ph: (269) 342-0606 | Mental Health Clinic 1514 W Milham Ave Portage MI 49024-1296 Ph: (269) 342-0606 |
| NPI Number | 1184822769 |
|---|---|
| Provider Enumeration Date | 07/05/2007 |
| Last Update Date | 10/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184822769 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 6401009051 (Michigan) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | RM4301052512 (Michigan) | Primary |
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