Healthcare Provider Details

I. General information

NPI: 1790703502
Provider Name (Legal Business Name): MPA GROUP LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 S EUCLID AVE
BAY CITY MI
48706
US

IV. Provider business mailing address

1217 S EUCLID AVE
BAY CITY MI
48706
US

V. Phone/Fax

Practice location:
  • Phone: 989-667-9661
  • Fax: 989-667-9680
Mailing address:
  • Phone: 989-667-9661
  • Fax: 989-667-9680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. RONALD DUANE LEIX
Title or Position: CEO
Credential: MBA
Phone: 989-667-9661