| Trauma And Addiction Solutions Pllc | |
|
121 N Pine River St Ithaca MI 48847-1039 | |
| (989) 287-0662 | |
| Not Available |
| Full Name | Trauma And Addiction Solutions Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 121 N Pine River St, Ithaca, Michigan |
| Authorized Official Name and Position | Matthew Stack (OWNER) |
| Authorized Official Contact | 9892870662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trauma And Addiction Solutions Pllc 1551 N Ferris Rd Sumner MI 48889-8718 Ph: (989) 287-0662 | Trauma And Addiction Solutions Pllc 121 N Pine River St Ithaca MI 48847-1039 Ph: (989) 287-0662 |
| NPI Number | 1174381974 |
|---|---|
| Provider Enumeration Date | 03/07/2024 |
| Last Update Date | 03/11/2024 |
| Certification Date | 03/11/2024 |
| Medicare PECOS PAC ID | 3577903913 |
|---|---|
| Medicare Enrollment ID | O20240501003889 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174381974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Mindful Therapy, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 122 N Maple St, Ithaca, MI 48847 Phone: 989-388-4185 Fax: 989-388-4187 |