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NPI Code Detail

MEDICARE: BALVIC HEALTH INC

MEDICARE: BALVIC HEALTH 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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1275483927
Entity Type Code : Organization
Provider Name (Legal Business Name) : BALVIC HEALTH INC
Provider Business Mailing Address
First Line : 15565 NORTHLAND DR W STE 505W
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48075-5307
Country : US
Telephone Number : 248-228-2640
Fax Number : 248-213-9580
Provider Business Practice Location Address
First Line : 15565 NORTHLAND DR W STE 505W
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48075-5307
Country : US
Telephone Number : 248-228-2640
Fax Number : 248-213-9580
Authorized Official
Title or Position : OWNER
Name : BARBARA RICHIE
Credential : NP
Telephone Number : 248-228-2640
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “BALVIC HEALTH INC ” Practice Location

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