Healthcare Provider Details

I. General information

NPI: 1619075942
Provider Name (Legal Business Name): ACCESS BEHAVIORAL HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 04/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42189 ANN ARBOR RD E
PLYMOUTH MI
48170-4370
US

IV. Provider business mailing address

42189 ANN ARBOR RD E
PLYMOUTH MI
48170-4370
US

V. Phone/Fax

Practice location:
  • Phone: 734-453-5603
  • Fax: 734-453-5619
Mailing address:
  • Phone: 734-453-5603
  • Fax: 734-453-5619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. DONALD LEROY WARNER JR.
Title or Position: PRESIDENT
Credential: MSW
Phone: 734-453-5603