Healthcare Provider Details
I. General information
NPI: 1255470233
Provider Name (Legal Business Name): IHA HEALTH SERVICES CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2007
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5315 ELLIOTT DR STE 201
YPSILANTI MI
48197-8634
US
IV. Provider business mailing address
24 FRANK LLOYD WRIGHT DR PO BOX 0446 LOBBY J
ANN ARBOR MI
48105-9484
US
V. Phone/Fax
- Phone: 734-712-8150
- Fax: 734-712-8151
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CYNTHIA
A
ELLIOTT
Title or Position: VP/CHIEF OPERATING OFFICER
Credential:
Phone: 734-747-6766