SAMUELSON ENTERPRISES PLLC NPI 1386152296

NPI Information

NPI: 1386152296
Provider Name: SAMUELSON ENTERPRISES, PLLC

Doing Business As: GRACE WELLNESS CLINIC

Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
3930 MOUNT VERNON DR
BLOOMFIELD HILLS, MI
ZIP 48301
Phone: (202) 262-2218
Get Directions

SAMUELSON ENTERPRISES, PLLC is a health service clinic center in Bloomfield Hills, MI. SAMUELSON ENTERPRISES, PLLC NPI is 1386152296. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Grace Wellness Clinic.

The provider's business location address is:

3930 MOUNT VERNON DR
BLOOMFIELD HILLS, MI
ZIP 48301-226
Phone: (202) 262-2218

The provider's authorized official is Bensson Varghese Samuel .
The authorized official title is Director/owner and has the following contact phone number (248) 792-9864.

The enumeration date for this NPI number is 1/12/2018 and was last updated on 1/12/2018.

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	License State	Primary
1	207P00000X	Emergency Medicine			No
2	207RC0000X	Internal Medicine	Cardiovascular Disease		No
3	207RH0005X	Internal Medicine	Hypertension Specialist		No
4	207RN0300X	Internal Medicine	Nephrology		No
5	207T00000X	Neurological Surgery			No
6	251E00000X	Home Health			No
7	251G00000X	Hospice Care, Community Based		MICHIGAN	No
8	261QC1800X	Clinic/Center	Corporate Health	MICHIGAN	No
9	261QE0700X	Clinic/Center	End-Stage Renal Disease (ESRD) Treatment		No
10	261QH0100X	Clinic/Center	Health Service	MICHIGAN	Yes
11	261QI0500X	Clinic/Center	Infusion Therapy	MICHIGAN	No
12	305S00000X	Point of Service			No
13	3336H0001X	Pharmacy	Home Infusion Therapy Pharmacy		No
14	343800000X	Secured Medical Transport (VAN)			No
15	385HR2050X	Respite Care	Respite Care Camp		No

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	1710240403	MEDICAID	PENNSYLVANIA

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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