Basic Information
| Provider Information | |||||||||
| NPI: | 1144381245 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHC OF MICHIGAN LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6100 TOWER CIR STE 1000 | ||||||||
| Address2: | |||||||||
| City: | FRANKLIN | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370671509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6158611000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 35031 23 MILE RD | ||||||||
| Address2: | |||||||||
| City: | NEW BALTIMORE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480473649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5857255777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2006 | ||||||||
| LastUpdateDate: | 09/25/2018 | ||||||||
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| AuthorizedOfficialLastName: | HOWARD | ||||||||
| AuthorizedOfficialFirstName: | CHRISTOPHER | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR, VP & SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 6158616000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 283Q00000X | MI | Y | Hospitals | Psychiatric Hospital |
No ID Information.