Basic Information
Provider Information
NPI: 1477141356
EntityType: 2
ReplacementNPI:  
OrganizationName: HEGIRA HEALTH, INC.
LastName:  
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Mailing Information
Address1: 37450 SCHOOLCRAFT RD STE 110
Address2:  
City: LIVONIA
State: MI
PostalCode: 481501000
CountryCode: US
TelephoneNumber: 7344584604
FaxNumber: 7344584611
Practice Location
Address1: 8623 N WAYNE RD STE 104
Address2:  
City: WESTLAND
State: MI
PostalCode: 481851137
CountryCode: US
TelephoneNumber: 7347420191
FaxNumber: 7347935312
Other Information
ProviderEnumerationDate: 01/06/2021
LastUpdateDate: 08/09/2022
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: ZUNIGA
AuthorizedOfficialFirstName: CAROL
AuthorizedOfficialMiddleName: L.
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 7344991513
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MS.
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AuthorizedOfficialCredential:  
NPICertificationDate: 08/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000X  N AgenciesCommunity/Behavioral Health 
261QP2300X  Y Ambulatory Health Care FacilitiesClinic/CenterPrimary Care

No ID Information.


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