| Gretchen's Place | |
|
25 Owen St Belleville MI 48111-2921 | |
| (734) 699-5400 | |
| Not Available |
| Full Name | Gretchen's Place |
|---|---|
| Speciality | Clinic/Center |
| Location | 25 Owen St, Belleville, Michigan |
| Authorized Official Name and Position | Deodge Hill (OWNER) |
| Authorized Official Contact | 7346995400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gretchen's Place 46036 Michigan Ave # 318 Canton MI 48188-2304 Ph: () - | Gretchen's Place 25 Owen St Belleville MI 48111-2921 Ph: (734) 699-5400 |
| NPI Number | 1013537802 |
|---|---|
| Provider Enumeration Date | 04/21/2020 |
| Last Update Date | 08/12/2020 |
| Medicare PECOS PAC ID | 3678972684 |
|---|---|
| Medicare Enrollment ID | O20210525000538 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013537802 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Zakari M Tata |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871591313 PECOS PAC ID: 9436049806 Enrollment ID: I20040318001713 |
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