Northeast Guidance Center | |
12800 E Warren Ave Detroit MI 48215-2601 | |
(313) 824-8000 | |
(313) 824-5589 |
Full Name | Northeast Guidance Center |
---|---|
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 12800 E Warren Ave, Detroit, Michigan |
Authorized Official Name and Position | Sue Nederlander (CHIEF FINANCIAL OFFICE) |
Authorized Official Contact | 3138245542 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Northeast Guidance Center 2900 Conner Ave Bldg A Detroit MI 48215-2061 Ph: (313) 308-1400 | Northeast Guidance Center 12800 E Warren Ave Detroit MI 48215-2601 Ph: (313) 824-8000 |
NPI Number | 1922037134 |
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Provider Enumeration Date | 07/01/2006 |
Last Update Date | 07/26/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922037134 | NPI | - | NPPES |
104682983 | Medicaid | MI | |
21-3119549 | Medicaid | MI | |
750910874 | Other | MI | BLUE CROSS BLUE SHEILD MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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