Rose Oak Mental Health Pllc | |
11308 Autumn Breeze Trl Ste 1 Clio MI 48420-1592 | |
(989) 996-5544 | |
Not Available |
Full Name | Rose Oak Mental Health Pllc |
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Speciality | Social Worker |
Location | 11308 Autumn Breeze Trl Ste 1, Clio, Michigan |
Authorized Official Name and Position | Destiny Ernestine Reikowsky (OWNER/CLINICAL THERAPIST) |
Authorized Official Contact | 9899965544 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Rose Oak Mental Health Pllc 11308 Autumn Breeze Trl Ste 1 Clio MI 48420-1592 Ph: (989) 996-5544 | Rose Oak Mental Health Pllc 11308 Autumn Breeze Trl Ste 1 Clio MI 48420-1592 Ph: (989) 996-5544 |
NPI Number | 1497517288 |
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Provider Enumeration Date | 01/26/2024 |
Last Update Date | 03/07/2024 |
Certification Date | 03/07/2024 |
Medicare PECOS PAC ID | 8820436660 |
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Medicare Enrollment ID | O20240329001180 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497517288 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
104100000X | Social Worker | (* (Not Available)) | Primary |
Provider Name | Destiny Reikowsky |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1518450840 PECOS PAC ID: 6103285036 Enrollment ID: I20230710002610 |
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