GRAND RIVER HEALTH CENTER PLC NPI 1689646846

NPI Information

NPI: 1689646846
Provider Name: GRAND RIVER HEALTH CENTER, PLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 23D0694695

Address:
19460 GRAND RIVER AVE
DETROIT, MI
ZIP 48223
Phone: (313) 387-1097
Get Directions

GRAND RIVER HEALTH CENTER, PLC is a family medicine in Detroit, MI. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GRAND RIVER HEALTH CENTER, PLC NPI is 1689646846. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

19460 GRAND RIVER AVE
DETROIT, MI
ZIP 48223-200
Phone: (313) 387-1097
Fax: (313) 387-8795

The provider's authorized official is Dennis Treece .
The authorized official title is Director and has the following contact phone number (734) 266-2780.

The CLIA number assigned to this NPI record is 23D0694695 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2006 and was last updated on 10/19/2007.

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
1	207R00000X	Internal Medicine				No
2	207Q00000X	Family Medicine				Yes

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	0N63770	MEDICARE PIN

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: 11/14/2023

NPI Synchronization or Removal

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