Provider Demographics
NPI:1144055997
Name:ROBINSON, MICHAEL ANDRE II
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANDRE
Last Name:ROBINSON
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 W CARIBBEAN DR
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-4998
Mailing Address - Country:US
Mailing Address - Phone:202-880-5147
Mailing Address - Fax:
Practice Address - Street 1:252 W CARIBBEAN DR
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-4998
Practice Address - Country:US
Practice Address - Phone:202-880-5147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children