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16523 S Water Tower Dr Kincheloe MI 49788-1592 | |
(906) 495-4351 | |
Not Available |
Full Name | |
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Speciality | Psychiatric Unit |
Location | 16523 S Water Tower Dr, Kincheloe, Michigan |
Authorized Official Name and Position | Kevin Kalchik (CEO) |
Authorized Official Contact | 9066354460 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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16523 S Water Tower Dr Kincheloe MI 49788-1592 Ph: (906) 495-4351 | 16523 S Water Tower Dr Kincheloe MI 49788-1592 Ph: (906) 495-4351 |
NPI Number | 1629260203 |
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Provider Enumeration Date | 08/16/2007 |
Last Update Date | 10/05/2022 |
Certification Date | 10/05/2022 |
Medicare PECOS PAC ID | 7315936481 |
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Medicare Enrollment ID | O20071002000653 |
Identifier | Type | State | Issuer |
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1629260203 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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273R00000X | Psychiatric Unit | 170020 (Michigan) | Primary |