| Midwest Detox Llc | |
|
31153 Plymouth Rd Ste 105 Livonia MI 48150-2134 | |
| (231) 409-0606 | |
| Not Available |
| Full Name | Midwest Detox Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 31153 Plymouth Rd Ste 105, Livonia, Michigan |
| Authorized Official Name and Position | Donovan Miske (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3134440167 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Detox Llc 31153 Plymouth Rd Ste 105 Livonia MI 48150-2134 Ph: () - | Midwest Detox Llc 31153 Plymouth Rd Ste 105 Livonia MI 48150-2134 Ph: (231) 409-0606 |
| NPI Number | 1316690753 |
|---|---|
| Provider Enumeration Date | 01/26/2022 |
| Last Update Date | 01/26/2022 |
| Certification Date | 01/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316690753 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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