MEDICARE: HENRY FORD BEHAVIORAL HEALTH- CLINTON OAKS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1619900396
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRY FORD BEHAVIORAL HEALTH- CLINTON OAKS

Provider Business Mailing Address
First Line	:	42633 GARFIELD RD
Second Line	:	SUITE 314
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-5033
Country	:	US
Telephone Number	:	586-226-7007
Fax Number	:	586-226-7033

Provider Business Practice Location Address
First Line	:	42633 GARFIELD RD
Second Line	:	SUITE 314
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-5033
Country	:	US
Telephone Number	:	586-226-7007
Fax Number	:	586-226-7033

Authorized Official
Title or Position	:	SR. V. P.
Name	:	MR. JAMES CONNELLY
Credential	:
Telephone Number	:	313-874-8714

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	09/11/2025

Similar Medicare Providers

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Practice Location Address:

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1235337866 — WENDY BERTGES YOST PH.D.
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1194823401 — JOAN ZAREMBA MSW
Practice Location Address:

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