Healthcare Provider Details

I. General information

NPI: 1245418151
Provider Name (Legal Business Name): OAKWOOD CHILD AND ADOLESECENT HEALTH CARE CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20352 EUREKA RD. OAKWOOD TEEN HEALTH CENTER-TAYLOR
TAYLOR MI
48180-4835
US

IV. Provider business mailing address

26901 BEAUMONT BLVD
SOUTHFIELD MI
48033-3849
US

V. Phone/Fax

Practice location:
  • Phone: 734-942-2273
  • Fax:
Mailing address:
  • Phone: 947-522-1963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW E COX
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 947-522-3333