Provider Demographics
NPI:1073191318
Name:MICHIGAN EVALUATIONS AND ASSESSMENTS, LLC
Entity Type:Organization
Organization Name:MICHIGAN EVALUATIONS AND ASSESSMENTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-300-9918
Mailing Address - Street 1:31700 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-3407
Mailing Address - Country:US
Mailing Address - Phone:313-300-9918
Mailing Address - Fax:
Practice Address - Street 1:31700 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-3407
Practice Address - Country:US
Practice Address - Phone:313-300-9918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1396135026Medicaid