Provider Demographics
NPI:1548683980
Name:UNIVERSAL HEALTH AND HEALING CENTER
Entity type:Organization
Organization Name:UNIVERSAL HEALTH AND HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ASSISTANT
Authorized Official - Prefix:MISS
Authorized Official - First Name:GWYNNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-920-2546
Mailing Address - Street 1:28755 SCHOENHERR RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088-4395
Mailing Address - Country:US
Mailing Address - Phone:586-920-2546
Mailing Address - Fax:586-920-2200
Practice Address - Street 1:28755 SCHOENHERR RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-4395
Practice Address - Country:US
Practice Address - Phone:586-920-2546
Practice Address - Fax:586-920-2200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012427101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty