MICHIGAN INSTITUTE OF PERFORMANCE AND HEALTH NPI 1174041321

NPI Information

  • NPI: 1174041321
  • Provider Name: MICHIGAN INSTITUTE OF PERFORMANCE AND HEALTH
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • Address: 43902 WOODWARD AVE STE 230
    BLOOMFIELD HILLS, MI
    ZIP 48302
  • Phone: (248) 481-8428

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NPI Details

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 License Number License State Primary
1261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
2261QH0100XClinic/CenterHealth ServiceNo
3261QM1100XClinic/CenterMilitary/U.S. Coast Guard OutpatientNo
4261QM0850XClinic/CenterAdult Mental HealthNo
5251S00000XCommunity/Behavioral HealthNo
6261QC1500XClinic/CenterCommunity HealthNo
7324500000XSubstance Abuse Rehabilitation FacilityNo
83245S0500XSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, ChildrenNo
9261QM1300XClinic/CenterMulti-SpecialtyYes

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
1VC0005376MEDICAIDMICHIGAN

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: 3/30/2025

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