Healthcare Provider Details

I. General information

NPI: 1912384728
Provider Name (Legal Business Name): MULTICARE HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2015
Last Update Date: 05/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28585 SCHOENHERR RD
WARREN MI
48088
US

IV. Provider business mailing address

28585 SCHOENHERR RD
WARREN MI
48088
US

V. Phone/Fax

Practice location:
  • Phone: 586-393-5765
  • Fax: 586-393-5790
Mailing address:
  • Phone: 586-393-5765
  • Fax: 586-393-5790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: JEFFERY ALLAN COOK
Title or Position: PRESIDENT
Credential: D.C.
Phone: 586-393-5765