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NPI Code Detail

MEDICARE: MACOMB OAKLAND REGIONAL CENTER INC.

MEDICARE: MACOMB OAKLAND REGIONAL CENTER INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1023199965
Entity Type Code : Organization
Provider Name (Legal Business Name) : MACOMB OAKLAND REGIONAL CENTER INC.
Provider Business Mailing Address
First Line : 2399 E WALTON BLVD
Second Line :
City : AUBURN HILLS
State : MI
Zip : 48326-1955
Country : US
Telephone Number : 586-263-8700
Fax Number :
Provider Business Practice Location Address
First Line : 2399 E WALTON BLVD
Second Line :
City : AUBURN HILLS
State : MI
Zip : 48326-1955
Country : US
Telephone Number : 248-475-6300
Fax Number :
Authorized Official
Title or Position : PRESIDENT & CEO
Name : MR. BRENT WIRTH
Credential :
Telephone Number : 248-475-6400
Provider Enumeration Date : 10/18/2006
Last Update Date : 01/15/2025

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Directions to “MACOMB OAKLAND REGIONAL CENTER INC. ” Practice Location

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