| The Wellness Plan-keys Grace Clinic | |
|
27321 Hampden St Rm 202 Madison Heights MI 48071-3113 | |
| (313) 202-8660 | |
| Not Available |
| Full Name | The Wellness Plan-keys Grace Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 27321 Hampden St Rm 202, Madison Heights, Michigan |
| Authorized Official Name and Position | Sherri Atwater (COMPLIANCE AND CREDENTIALING) |
| Authorized Official Contact | 3132028500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Wellness Plan-keys Grace Clinic 7700 2nd Ave Detroit MI 48202-2411 Ph: (313) 202-8660 | The Wellness Plan-keys Grace Clinic 27321 Hampden St Rm 202 Madison Heights MI 48071-3113 Ph: (313) 202-8660 |
| NPI Number | 1114420353 |
|---|---|
| Provider Enumeration Date | 03/14/2018 |
| Last Update Date | 07/30/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114420353 | NPI | - | NPPES |
| 0M37210 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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