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NPI Code Detail

MEDICARE: EASTERSEALS MORC HEALTH CARE, INC.

MEDICARE: EASTERSEALS MORC HEALTH CARE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency1041C0700XMI

General Provider Information

NPI Number : 1164721890
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTERSEALS MORC HEALTH CARE, INC.
Provider Business Mailing Address
First Line : 2399 E WALTON BLVD
Second Line :
City : AUBURN HILLS
State : MI
Zip : 48326-1955
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 51229 CENTURY CT
Second Line :
City : WIXOM
State : MI
Zip : 48393-2074
Country : US
Telephone Number : 248-529-1008
Fax Number : 248-451-2901
Authorized Official
Title or Position : PRESIDENT & CEO
Name : BRENT WIRTH
Credential :
Telephone Number : 248-475-6300
Provider Enumeration Date : 03/21/2011
Last Update Date : 10/01/2024

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