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26522 Van Dyke Ave Center Line MI 48015-1221 | |
| (248) 634-6303 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 26522 Van Dyke Ave, Center Line, Michigan |
| Authorized Official Name and Position | Ismail B Sendi (EXECUTIVE MEDICAL DIRECTOR) |
| Authorized Official Contact | 2486346303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12850 Fountain Sq Ste 106 Davisburg MI 48350-2552 Ph: (248) 634-6303 | 26522 Van Dyke Ave Center Line MI 48015-1221 Ph: (248) 634-6303 |
| NPI Number | 1558666891 |
|---|---|
| Provider Enumeration Date | 01/18/2011 |
| Last Update Date | 01/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558666891 | NPI | - | NPPES |
| 750910681 | Other | MI | BLUE CROSS BLUE SHIELD MICHIGAN |
| 018954 | Other | MI | MIDWEST HEALTH PLAN |
| 0910932 | Other | MI | BLUE CARE NETWORK |
| 5055 | Other | MI | MACOMB COUNTY CMH |
| XX19153 | Other | MI | HEALTHPLUS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Still Mind Therapy Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 7325 Bernice, Center Line, MI 48015 Phone: 586-899-7516 | |
Life Line Psychiatric Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 25501 Van Dyke Ave, Center Line, MI 48015 Phone: 586-755-8911 | |