| New Vantage Llc | |
|
21379 Tulane Ave Apt 201 Farmington Hills MI 48336-5670 | |
| (313) 829-3034 | |
| Not Available |
| Full Name | New Vantage Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 21379 Tulane Ave Apt 201, Farmington Hills, Michigan |
| Authorized Official Name and Position | Sireece Bass (MEMBER) |
| Authorized Official Contact | 3138293034 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Vantage Llc 21379 Tulane Ave Apt 201 Farmington Hills MI 48336-5670 Ph: (313) 829-3034 | New Vantage Llc 21379 Tulane Ave Apt 201 Farmington Hills MI 48336-5670 Ph: (313) 829-3034 |
| NPI Number | 1386075919 |
|---|---|
| Provider Enumeration Date | 12/08/2013 |
| Last Update Date | 12/08/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386075919 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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