Healthcare Provider Details

I. General information

NPI: 1225185820
Provider Name (Legal Business Name): IHA HEALTH SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 02/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 S MAIN ST
CHELSEA MI
48118-1434
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DR PO BOX 0446, LOBBY J
ANN ARBOR MI
48105-9484
US

V. Phone/Fax

Practice location:
  • Phone: 734-475-9175
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA ELLIOTT
Title or Position: VP /CHIEF OPERATING OFFIER
Credential:
Phone: 734-747-6766