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General NPI Number Information
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NPI Number | 1437961513
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Entity Type | Organization
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Legal Business Name | MY MENTAL WELLNESS, INC
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 14350 TIREMAN ST
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City | DETROIT
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State | MI
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Zip | 48228-6100
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Country | US
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Telephone | 313-584-4143
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Fax | 313-914-7187
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Provider Business Mailing Address
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Address Line | 14350 TIREMAN ST
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City | DETROIT
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State | MI
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Zip | 48228-6100
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Country | US
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Telephone | 313-584-4143
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | MR. DANISH SYED HASAN
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Credential |
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Telephone | 313-584-4143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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