| Rootwork Llc | |
|
11000 W Mcnichols Rd Ste 323 Detroit MI 48221-2393 | |
| (312) 480-6855 | |
| Not Available |
| Full Name | Rootwork Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 11000 W Mcnichols Rd Ste 323, Detroit, Michigan |
| Authorized Official Name and Position | Danielle Shannon (OWNER) |
| Authorized Official Contact | 3124806855 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rootwork Llc 11000 W Mcnichols Rd Ste 323 Detroit MI 48221-2393 Ph: (312) 480-6855 | Rootwork Llc 11000 W Mcnichols Rd Ste 323 Detroit MI 48221-2393 Ph: (312) 480-6855 |
| NPI Number | 1659079663 |
|---|---|
| Provider Enumeration Date | 02/20/2023 |
| Last Update Date | 02/20/2023 |
| Certification Date | 02/19/2023 |
| Medicare PECOS PAC ID | 4082074448 |
|---|---|
| Medicare Enrollment ID | O20230717001795 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659079663 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Danielle N Shannon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689014888 PECOS PAC ID: 3072889872 Enrollment ID: I20230717001868 |
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