MR. LARRY J GRAHAM NPI 1710528617

NPI Information

NPI: 1710528617
Provider Name: MR. LARRY J GRAHAM
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Individual
Address:
1284 MAURER AVE
PONTIAC, MI
ZIP 48342
Phone: (248) 252-1427
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MR. Larry J Graham is a community based residential treatment facility mental illness in Pontiac, MI. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. MR. Larry J Graham NPI is 1710528617. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1284 MAURER AVE
PONTIAC, MI
ZIP 48342-960
Phone: (248) 252-1427

The enumeration date for this NPI number is 10/1/2019 and was last updated on 10/1/2019.

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	320800000X	Community Based Residential Treatment Facility, Mental Illness				Yes

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: 5/5/2024

NPI Synchronization or Removal

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