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General NPI Number Information
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NPI Number | 1477821502
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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 | 12/03/2011
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 1222 CATALPA DR
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City | ROYAL OAK
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State | MI
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Zip | 48067-1127
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Country | US
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Telephone | 248-544-2034
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Fax | 248-544-2152
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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 | 248-475-6300
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Fax |
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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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