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General NPI Number Information
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NPI Number | 1134592702
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Entity Type | Organization
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Legal Business Name | BIO-MED BEHAVIORAL HEALTH CARE
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Dates
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Enumeration Date | 11/04/2015
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Last Update Date | 11/04/2015
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Provider Practice Location Address
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Address Line | 31581 GRATIOT AVE
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City | ROSEVILLE
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State | MI
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Zip | 48066-4528
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Country | US
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Telephone | 586-612-6600
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Fax |
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Provider Business Mailing Address
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Address Line | 22134 PLEASANT AVE
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City | EASTPOINTE
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State | MI
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Zip | 48021-2476
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | HEATHER FRANCIS
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Credential | LLPC
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Telephone | 586-612-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number | 6401014456
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License Number State | MI
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