MEDICARE: MICHIGAN BEHAVIORAL HEALTH

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1629401237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHIGAN BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	2525 CROOKS RD
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-4733
Country	:	US
Telephone Number	:	248-703-1897
Fax Number	:

Provider Business Practice Location Address
First Line	:	2525 CROOKS RD
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-4733
Country	:	US
Telephone Number	:	248-703-1897
Fax Number	:

Authorized Official
Title or Position	:	PSYCHIATRIST
Name	:	DR. KALAPPURACKAL C JOSEPH
Credential	:	MD
Telephone Number	:	248-703-1897

Provider Enumeration Date	:	08/19/2013
Last Update Date	:	08/19/2013

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Practice Location Address:

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Directions to “MICHIGAN BEHAVIORAL HEALTH ” Practice Location

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