Healthcare Provider Details
I. General information
NPI: 1669478921
Provider Name (Legal Business Name): PERSONAL & FAMILY ADJUSTMENT CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2005
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
700 N OLD WOODWARD AVE STE 300
BIRMINGHAM MI
48009-1338
US
IV. Provider business mailing address
700 N OLD WOODWARD AVE STE 300
BIRMINGHAM MI
48009-1338
US
V. Phone/Fax
- Phone: 248-642-8263
- Fax: 248-642-3862
- Phone: 248-642-8263
- Fax: 248-642-3862
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ALDONA
M
VALVIVONIS
Title or Position: PRESIDENT
Credential: PH. D.
Phone: 248-642-8263