Healthcare Provider Details
I. General information
NPI: 1821025347
Provider Name (Legal Business Name): APEX BEHAVIORAL HEALTH,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/28/2006
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1547 S WAYNE RD
WESTLAND MI
48186-5436
US
IV. Provider business mailing address
1547 S WAYNE RD
WESTLAND MI
48186-5436
US
V. Phone/Fax
- Phone: 734-729-3133
- Fax: 734-405-0175
- Phone: 734-729-3133
- Fax: 734-405-0175
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
THOMAS
EDGAR
JOHNSON
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 734-729-3133