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1558544130

NPI Code Detail

MEDICARE: MORIAH, INCORPORATED

MEDICARE: MORIAH, INCORPORATED

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	101Y00000X	Counselor
2	103K00000X	Behavior Analyst
3	1041C0700X	Clinical Social Worker
4	163WP0808X	Psychiatric/Mental Health Registered Nurse
5	163WW0000X	Wound Care Registered Nurse
6	164W00000X	Licensed Practical Nurse
7	174H00000X	Health Educator
8	235Z00000X	Speech-Language Pathologist
9	251S00000X	Community/Behavioral Health Agency
10	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
11	320700000X	Physical Disabilities Residential Treatment Facility	AL810015274	MI
12	320800000X	Mental Illness Community Based Residential Treatment Facility
13	323P00000X	Psychiatric Residential Treatment Facility
14	324500000X	Substance Abuse Rehabilitation Facility	SA0810348	MI
15	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1558544130
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORIAH, INCORPORATED

Provider Business Mailing Address
First Line	:	3200 E EISENHOWER PKWY
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48108-3231
Country	:	US
Telephone Number	:	734-677-0070
Fax Number	:	734-677-0890

Provider Business Practice Location Address
First Line	:	3200 E EISENHOWER PKWY
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48108-3231
Country	:	US
Telephone Number	:	734-677-0070
Fax Number	:	734-677-0890

Authorized Official
Title or Position	:	BILLING AND COLLECTIONS MANAGER
Name	:	TANJA TADDONIO
Credential	:
Telephone Number	:	734-677-0070

Provider Enumeration Date	:	12/06/2007
Last Update Date	:	11/16/2020

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Directions to “MORIAH, INCORPORATED ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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