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NPI Code Detail

MEDICARE: WARREN MEDICAL AND THERAPY CENTER, LLC

MEDICARE: WARREN MEDICAL AND THERAPY CENTER, LLC
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
1305S00000XPoint of Service

General Provider Information

NPI Number : 1174992796
Entity Type Code : Organization
Provider Name (Legal Business Name) : WARREN MEDICAL AND THERAPY CENTER, LLC
Provider Business Mailing Address
First Line : 15841 W WARREN AVE
Second Line : #37
City : DETROIT
State : MI
Zip : 48228-3737
Country : US
Telephone Number : 313-254-9659
Fax Number :
Provider Business Practice Location Address
First Line : 15841 W WARREN AVE
Second Line : #37
City : DETROIT
State : MI
Zip : 48228-3737
Country : US
Telephone Number : 313-254-9659
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : MS. LISA MAUREEN MORRIS
Credential :
Telephone Number : 313-254-9659
Provider Enumeration Date : 09/24/2015
Last Update Date : 09/24/2015

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Directions to “WARREN MEDICAL AND THERAPY CENTER, LLC ” Practice Location

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