Healthcare Provider Details

I. General information

NPI: 1366639965
Provider Name (Legal Business Name): BIO-BEHAVIORAL CARE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 01/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28800 RYAN RD SUITE 320
WARREN MI
48092-4272
US

IV. Provider business mailing address

28800 RYAN RD SUITE 320
WARREN MI
48092-4272
US

V. Phone/Fax

Practice location:
  • Phone: 586-620-8100
  • Fax: 866-227-7418
Mailing address:
  • Phone: 586-620-8100
  • Fax: 866-227-7418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT A CLEMENTE
Title or Position: PRESIDENT
Credential: ESQ.
Phone: 586-620-8100