MEDICARE: CNS TOTAL 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
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1245593698
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CNS TOTAL CARE INC

Provider Business Mailing Address
First Line	:	38855 HILLS TECH DR
Second Line	:	STE 200
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-3421
Country	:	US
Telephone Number	:	248-745-4900
Fax Number	:

Provider Business Practice Location Address
First Line	:	38855 HILLS TECH DR
Second Line	:	STE 200
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48331-3421
Country	:	US
Telephone Number	:	248-745-4900
Fax Number	:

Authorized Official
Title or Position	:	OFFICIAL
Name	:	JOYCE H RADEMACHER
Credential	:
Telephone Number	:	248-745-4900

Provider Enumeration Date	:	06/20/2012
Last Update Date	:	06/20/2012

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