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NPI 1376526616

NPI 1376526616 : EASTERSEALS MORC HEALTH CARE, INC. : AUBURN HILLS, MI

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General NPI Number Information
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    NPI Number           |    1376526616
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    Entity Type          |    Organization 
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    Legal Business Name  |    EASTERSEALS MORC HEALTH CARE, INC. 
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Dates
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    Enumeration Date     |    11/21/2005
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    Last Update Date     |    04/15/2025
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Provider Practice Location Address
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    Address Line         |    2399 E WALTON BLVD 
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    City                 |    AUBURN HILLS
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    State                |    MI
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    Zip                  |    48326-1955
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    Country              |    US
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    Telephone            |    248-475-6400
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    Fax                  |    248-475-6402
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Provider Business Mailing Address
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    Address Line         |    2399 E WALTON BLVD 
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    City                 |    AUBURN HILLS
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    State                |    MI
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    Zip                  |    48326-1955
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    Country              |    US
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    Telephone            |    248-475-6400
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    Fax                  |    248-475-6402
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Authorized Official
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    Title or Position    |    PRESIDENT & CEO
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    Name                 |     BRENT  WIRTH 
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    Credential           |    
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    Telephone            |    248-475-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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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        |    251V00000X
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    Taxonomy Name        |    Voluntary or Charitable Agency
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    2084P0800X
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    Taxonomy Name        |    Psychiatry Physician
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    License Number       |    
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    License Number State |    
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