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NPI Code Detail

MEDICARE: EASTERSEALS MORC HEALTH CARE, INC.

MEDICARE: EASTERSEALS MORC HEALTH CARE, 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
2251V00000XVoluntary or Charitable Agency
32084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1376526616
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTERSEALS MORC HEALTH CARE, 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 : 248-475-6400
Fax Number : 248-475-6402
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 : 248-475-6400
Fax Number : 248-475-6402
Authorized Official
Title or Position : PRESIDENT & CEO
Name : BRENT WIRTH
Credential :
Telephone Number : 248-475-6300
Provider Enumeration Date : 11/21/2005
Last Update Date : 04/15/2025

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