Healthcare Provider Details
I. General information
NPI: 1447851233
Provider Name (Legal Business Name): MERCY PLUS HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/06/2020
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
623 W WARWICK DR STE 2
ALMA MI
48801-1177
US
IV. Provider business mailing address
2521 N ELMS RD
FLUSHING MI
48433-9423
US
V. Phone/Fax
- Phone: 989-395-1421
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
GREG
MANTAI
Title or Position: CEO
Credential:
Phone: 810-487-5571