| Mind Medicine Inc | |
|
25882 Orchard Lake Rd Farmington Hills MI 48336-1292 | |
| (248) 426-7299 | |
| Not Available |
| Full Name | Mind Medicine Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 25882 Orchard Lake Rd, Farmington Hills, Michigan |
| Authorized Official Name and Position | Timothy Chapman (CEO) |
| Authorized Official Contact | 2486864469 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mind Medicine Inc Po Box 8171 Bloomfield Hills MI 48302-8171 Ph: (248) 686-4469 | Mind Medicine Inc 25882 Orchard Lake Rd Farmington Hills MI 48336-1292 Ph: (248) 426-7299 |
| NPI Number | 1376124925 |
|---|---|
| Provider Enumeration Date | 04/15/2021 |
| Last Update Date | 04/15/2021 |
| Certification Date | 04/15/2021 |
| Medicare PECOS PAC ID | 2466827647 |
|---|---|
| Medicare Enrollment ID | O20230403000364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376124925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Timothy Lamar Chapman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023056199 PECOS PAC ID: 0244294957 Enrollment ID: I20041112000769 |
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