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11585 Farmington Rd Livonia MI 48150-5729 | |
(313) 558-9958 | |
(313) 558-9941 |
Full Name | |
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Speciality | Community/Behavioral Health |
Location | 11585 Farmington Rd, Livonia, Michigan |
Authorized Official Name and Position | Vincent Darwiche (CEO) |
Authorized Official Contact | 3136948661 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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11585 Farmington Rd Livonia MI 48150-5729 Ph: (313) 558-9958 | 11585 Farmington Rd Livonia MI 48150-5729 Ph: (313) 558-9958 |
NPI Number | 1649057209 |
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Provider Enumeration Date | 09/08/2023 |
Last Update Date | 11/27/2023 |
Certification Date | 11/27/2023 |
Medicare PECOS PAC ID | 6709329915 |
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Medicare Enrollment ID | O20240617001220 |
Identifier | Type | State | Issuer |
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1649057209 | NPI | - | NPPES |
Provider Name | Stacey S Allen |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1801420708 PECOS PAC ID: 8921437328 Enrollment ID: I20200407000244 |
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