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General NPI Number Information
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NPI Number | 1679727523
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Entity Type | Organization
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Legal Business Name | MCCLAIN ASSOCIATES
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 18954 JAMES COUZENS FWY
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City | DETROIT
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State | MI
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Zip | 48235-2516
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Country | US
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Telephone | 313-864-5306
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7042
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City | BLOOMFIELD HILLS
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State | MI
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Zip | 48302-7042
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Country | US
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Telephone | 313-770-9976
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PROF. MICHAEL LANE MCCLAIN
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Credential | MA, LRT, CADC
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Telephone | 313-770-9976
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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 | 822974
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 823142
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License Number State | MI
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