MICHIGAN INSTITUTE OF PERFORMANCE AND HEALTH NPI 1174041321

NPI Information

NPI: 1174041321
Provider Name: MICHIGAN INSTITUTE OF PERFORMANCE AND HEALTH
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
43902 WOODWARD AVE STE 230
BLOOMFIELD HILLS, MI
ZIP 48302
Phone: (248) 481-8428
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MICHIGAN INSTITUTE OF PERFORMANCE AND HEALTH is a multi-specialty clinic center in Bloomfield Hills, MI. MICHIGAN INSTITUTE OF PERFORMANCE AND HEALTH NPI is 1174041321. The provider is registered as an organization entity type.

The provider's business location address is:

43902 WOODWARD AVE STE 230
BLOOMFIELD HILLS, MI
ZIP 48302-022
Phone: (248) 481-8428
Fax: (248) 977-5462

The provider's authorized official is Mark S. Wells .
The authorized official title is Owner/clinic Director and has the following contact phone number (248) 404-7151.

The enumeration date for this NPI number is 9/7/2017 and was last updated on 2/1/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
2	261QH0100X	Clinic/Center	Health Service	No
3	261QM1100X	Clinic/Center	Military/U.S. Coast Guard Outpatient	No
4	261QM0850X	Clinic/Center	Adult Mental Health	No
5	251S00000X	Community/Behavioral Health		No
6	261QC1500X	Clinic/Center	Community Health	No
7	324500000X	Substance Abuse Rehabilitation Facility		No
8	3245S0500X	Substance Abuse Rehabilitation Facility	Substance Abuse Treatment, Children	No
9	261QM1300X	Clinic/Center	Multi-Specialty	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	VC0005376	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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