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General NPI Number Information
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NPI Number | 1013276260
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Entity Type | Organization
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Legal Business Name | IHA HEALTH SERVICES CORPORATION
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 5361 MCAULEY DR
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City | YPSILANTI
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State | MI
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Zip | 48197-1011
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Country | US
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Telephone | 734-712-1300
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Fax | 734-222-3665
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Provider Business Mailing Address
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Address Line | 24 FRANK LLOYD WRIGHT DR # J2000
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City | ANN ARBOR
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State | MI
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Zip | 48105-9484
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Country | US
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Telephone | 734-747-6766
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Fax | 734-222-3100
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Authorized Official
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Title or Position | PRESIDENT AND COO
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Name | CYNTHIA ELLIOTT
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Credential |
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Telephone | 734-747-6766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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