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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 Agency

General Provider Information

NPI Number : 1629235924
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 : 248-475-6400
Fax Number : 248-475-6402
Provider Business Practice Location Address
First Line : 1685 BALDWIN AVE STE A
Second Line :
City : PONTIAC
State : MI
Zip : 48340-1242
Country : US
Telephone Number : 248-706-3450
Fax Number : 248-706-3455
Authorized Official
Title or Position : PRESIDENT & CEO
Name : BRENT WIRTH
Credential :
Telephone Number : 248-475-6400
Provider Enumeration Date : 05/22/2008
Last Update Date : 10/01/2024

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