Mental Health Clinic | |
1514 W Milham Ave Portage MI 49024-1296 | |
(269) 342-0606 | |
(269) 342-0919 |
Full Name | Mental Health Clinic |
---|---|
Speciality | Psychiatry & Neurology - Psychiatry |
Location | 1514 W Milham Ave, Portage, Michigan |
Authorized Official Name and Position | Ravinder P Mediratta (OWNER) |
Authorized Official Contact | 2693420606 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mental Health Clinic 1514 W Milham Ave Portage MI 49024-1296 Ph: (269) 342-0606 | Mental Health Clinic 1514 W Milham Ave Portage MI 49024-1296 Ph: (269) 342-0606 |
NPI Number | 1184822769 |
---|---|
Provider Enumeration Date | 07/05/2007 |
Last Update Date | 10/09/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184822769 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 6401009051 (Michigan) | Secondary |
2084P0800X | Psychiatry & Neurology - Psychiatry | RM4301052512 (Michigan) | Primary |
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