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NPI Code Detail

MEDICARE: POCS MENTAL HEALTH PC

MEDICARE: POCS MENTAL HEALTH PC
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
1207R00000XInternal Medicine Physician
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1689901993
Entity Type Code : Organization
Provider Name (Legal Business Name) : POCS MENTAL HEALTH PC
Provider Business Mailing Address
First Line : 34841 VETERANS PLZ
Second Line :
City : WAYNE
State : MI
Zip : 48184-1733
Country : US
Telephone Number : 313-292-7640
Fax Number : 313-292-9270
Provider Business Practice Location Address
First Line : 34841 VETERANS PLZ
Second Line :
City : WAYNE
State : MI
Zip : 48184-1733
Country : US
Telephone Number : 734-728-3446
Fax Number : 734-728-4893
Authorized Official
Title or Position : OWNER
Name : MR. COLIN KING
Credential : PHD. LP.
Telephone Number : 313-292-7640
Provider Enumeration Date : 11/06/2009
Last Update Date : 07/15/2014

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