Healthcare Provider Details

I. General information

NPI: 1942244785
Provider Name (Legal Business Name): HEALING HANDS FAMILY HEALTH CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20905 GREENFIELD RD STE 600
SOUTHFIELD MI
48075-5355
US

IV. Provider business mailing address

19785 W 12 MILE RD # 591
SOUTHFIELD MI
48076-2584
US

V. Phone/Fax

Practice location:
  • Phone: 586-646-2100
  • Fax: 586-327-1441
Mailing address:
  • Phone: 586-646-2100
  • Fax: 586-327-1441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301061672
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301061672
License Number StateMI

VIII. Authorized Official

Name: DR. CAMILLE JOHNSON
Title or Position: OWNER/PHYSICIAN
Credential: MD
Phone: 586-646-2100