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General NPI Number Information
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NPI Number | 1689485658
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Entity Type | Organization
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Legal Business Name | ZION HEALING CENTERS MI LLC
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 43777 N GROESBECK HWY
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City | CLINTON TWP
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State | MI
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Zip | 48036-1112
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Country | US
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Telephone | 586-899-8484
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Fax |
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Provider Business Mailing Address
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Address Line | 43777 N GROESBECK HWY
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City | CLINTON TWP
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State | MI
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Zip | 48036-1112
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Country | US
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Telephone | 586-899-8484
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | VICTOR IP
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Credential | TLLP
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Telephone | 586-764-5668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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