Organization · NPI-2

Premier Services Of Michigan, LLC

Clinic/Center, Methadone Clinic · Madison Heights, MI

NPI number1306098801

StatusActive

Last updated in NPPESFeb 10, 2024

Details

NPI: 1306098801
Entity type: Organization (NPI-2)
Legal business name: Premier Services Of Michigan, LLC
Organization subpart: No
Enumeration date: Oct 15, 2008
Certification date: Feb 10, 2024
Last updated: Feb 10, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QM2800X	Clinic/Center, Methadone Clinic	–	MI	Yes
101YA0400X	Counselor, Addiction (Substance Use Disorder)	–	–
251S00000X	Community/Behavioral Health	–	–
261QM0801X	Clinic/Center, Mental Health (Including Community Mental Health Center)	–	–
261QR0405X	Clinic/Center, Rehabilitation, Substance Use Disorder	–	–

Other names

Premier Care Madison Heights (Doing Business As)

Practice location

1400 E 12 Mile Rd
Madison Heights, MI 48071-2651

Phone 248-547-2223 · Fax 800-377-9518

Mailing address

Po Box 220
Sullivan, MO 63080-0220

Phone 573-860-2273

Authorized official

Cindy Gaither
Vp Revenue Cycle Mgmt
6022488886

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