| Meridian Health Services | |
|
1255 N Oakland Blvd Waterford MI 48327-1545 | |
| (248) 599-8999 | |
| (248) 406-0129 |
| Full Name | Meridian Health Services |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 1255 N Oakland Blvd, Waterford, Michigan |
| Authorized Official Name and Position | Richard Paige (CEO) |
| Authorized Official Contact | 2485998999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meridian Health Services 1255 N Oakland Blvd Waterford MI 48327-1545 Ph: (248) 599-8999 | Meridian Health Services 1255 N Oakland Blvd Waterford MI 48327-1545 Ph: (248) 599-8999 |
| NPI Number | 1003247362 |
|---|---|
| Provider Enumeration Date | 12/11/2013 |
| Last Update Date | 03/26/2020 |
| Certification Date | 03/26/2020 |
| Medicare PECOS PAC ID | 2365741998 |
|---|---|
| Medicare Enrollment ID | O20160503000377 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003247362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | 631281 (Michigan) | Primary |
| Provider Name | Faisal M Shareefuddin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538212485 PECOS PAC ID: 5799857454 Enrollment ID: I20080712000089 |
| Provider Name | Diane L Morris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164446464 PECOS PAC ID: 9335284272 Enrollment ID: I20100303000901 |
| Provider Name | Molly Anne Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780044131 PECOS PAC ID: 1850689092 Enrollment ID: I20161004001345 |
| Provider Name | Peggy Otterstetter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124561584 PECOS PAC ID: 7911282405 Enrollment ID: I20170324000238 |
| Provider Name | Ewa A Kubicz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821306663 PECOS PAC ID: 0143575159 Enrollment ID: I20180615000403 |
| Provider Name | Denise Ann Barney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144350133 PECOS PAC ID: 8527396001 Enrollment ID: I20190822000432 |
| Provider Name | Jessica Mara Crawford |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154847523 PECOS PAC ID: 7618319021 Enrollment ID: I20240530000441 |
| Provider Name | Marta Baldysz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700339355 PECOS PAC ID: 2769824127 Enrollment ID: I20240530002195 |
| Provider Name | Sarah Kendrick |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922466978 PECOS PAC ID: 0446793731 Enrollment ID: I20240614001159 |
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