Healthcare Provider Details

I. General information

NPI: 1124381793
Provider Name (Legal Business Name): OAKLAND INTEGRATED HEALTHCARE NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2012
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N TELEGRAPH RD STE 300A
PONTIAC MI
48341-1039
US

IV. Provider business mailing address

PO BOX 430150
PONTIAC MI
48343-0150
US

V. Phone/Fax

Practice location:
  • Phone: 248-724-7600
  • Fax: 248-636-4025
Mailing address:
  • Phone: 248-724-7600
  • Fax: 248-636-4025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBRA BRINSON
Title or Position: CEO
Credential:
Phone: 248-724-7438