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269 Summit Dr Waterford MI 48328-3364 | |
| (248) 599-8999 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 269 Summit Dr, Waterford, Michigan |
| Authorized Official Name and Position | Nicole Powell (HR/CREDENTIALING) |
| Authorized Official Contact | 2484612910 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1255 N Oakland Blvd Waterford MI 48327-1545 Ph: (248) 599-8999 | 269 Summit Dr Waterford MI 48328-3364 Ph: (248) 599-8999 |
| NPI Number | 1578014940 |
|---|---|
| Provider Enumeration Date | 10/20/2016 |
| Last Update Date | 01/07/2025 |
| Certification Date | 01/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578014940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (Michigan) | Primary |
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