Healthcare Provider Details

I. General information

NPI: 1477141356
Provider Name (Legal Business Name): HEGIRA HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2021
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8623 N WAYNE RD STE 104
WESTLAND MI
48185-1137
US

IV. Provider business mailing address

37450 SCHOOLCRAFT RD STE 110
LIVONIA MI
48150-1000
US

V. Phone/Fax

Practice location:
  • Phone: 734-742-0191
  • Fax: 734-793-5312
Mailing address:
  • Phone: 734-458-4604
  • Fax: 734-458-4611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. CAROL L. ZUNIGA
Title or Position: CEO
Credential:
Phone: 734-499-1513