| Psychiatric Services | |
|
5575 Conner Suite 208 Detroit MI 48213 | |
| (313) 909-0470 | |
| Not Available |
| Full Name | Psychiatric Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 5575 Conner, Detroit, Michigan |
| Authorized Official Name and Position | William W Martin (DIRECTOR) |
| Authorized Official Contact | 3139090470 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychiatric Services 969 Trombley Rd Grosse Pointe Park MI 48230-1836 Ph: (313) 909-0470 | Psychiatric Services 5575 Conner Suite 208 Detroit MI 48213 Ph: (313) 909-0470 |
| NPI Number | 1225368301 |
|---|---|
| Provider Enumeration Date | 01/12/2010 |
| Last Update Date | 01/12/2010 |
| Medicare PECOS PAC ID | 0345370011 |
|---|---|
| Medicare Enrollment ID | O20100608000157 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225368301 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 4301052880 (Michigan) | Primary |
| Provider Name | Joseph C Kirtland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790884658 PECOS PAC ID: 6709982424 Enrollment ID: I20070426000123 |
| Provider Name | William W Martin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508877317 PECOS PAC ID: 9133259807 Enrollment ID: I20100608000191 |
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