MEDICARE: ALL IS WELL MIHP

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	163W00000X	Registered Nurse

General Provider Information

NPI Number	:	1437001260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL IS WELL MIHP

Provider Business Mailing Address
First Line	:	49 TUXEDO ST
Second Line	:
City	:	HIGHLAND PARK
State	:	MI
Zip	:	48203-3532
Country	:	US
Telephone Number	:	313-418-2902
Fax Number	:

Provider Business Practice Location Address
First Line	:	49 TUXEDO ST
Second Line	:
City	:	HIGHLAND PARK
State	:	MI
Zip	:	48203-3532
Country	:	US
Telephone Number	:	313-418-2902
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TREVA LYNETTE GORDON
Credential	:	GORDON
Telephone Number	:	313-418-2902

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

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