Healthcare Provider Details

I. General information

NPI: 1437515061
Provider Name (Legal Business Name): Y-PCS GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2016
Last Update Date: 01/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23077 GREENFIELD RD STE 238
SOUTHFIELD MI
48075-3767
US

IV. Provider business mailing address

8499 WAHRMAN ST
ROMULUS MI
48174-4161
US

V. Phone/Fax

Practice location:
  • Phone: 313-412-1318
  • Fax: 248-809-6232
Mailing address:
  • Phone: 313-412-1318
  • Fax: 248-809-6232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberL760342
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code310500000X
TaxonomyMental Illness Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. WENDER DEAN TRIGGS
Title or Position: PRESIDENT
Credential:
Phone: 313-412-1318