| Aces Pediatric Behavioral Health Pllc | |
|
10823 N Straits Hwy Ste B Cheboygan MI 49721-9077 | |
| (231) 268-1149 | |
| (231) 268-3369 |
| Full Name | Aces Pediatric Behavioral Health Pllc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 10823 N Straits Hwy Ste B, Cheboygan, Michigan |
| Authorized Official Name and Position | Tamyra N Cooper (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2312681149 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aces Pediatric Behavioral Health Pllc Po Box 122 Cheboygan MI 49721-0122 Ph: (231) 268-1149 | Aces Pediatric Behavioral Health Pllc 10823 N Straits Hwy Ste B Cheboygan MI 49721-9077 Ph: (231) 268-1149 |
| NPI Number | 1033835707 |
|---|---|
| Provider Enumeration Date | 10/14/2022 |
| Last Update Date | 01/28/2023 |
| Certification Date | 01/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033835707 | NPI | - | NPPES |
| 1265098693 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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