Provider Demographics
NPI:1225523715
Name:EVANGELICAL HOMES OF MICHIGAN
Entity Type:Organization
Organization Name:EVANGELICAL HOMES OF MICHIGAN
Other - Org Name:THE REDIES OUTPATIENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GOVERNANCE/BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-871-5001
Mailing Address - Street 1:400 W RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:MI
Mailing Address - Zip Code:48176-1183
Mailing Address - Country:US
Mailing Address - Phone:734-295-9292
Mailing Address - Fax:
Practice Address - Street 1:400 W RUSSELL ST
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:MI
Practice Address - Zip Code:48176-1183
Practice Address - Country:US
Practice Address - Phone:734-295-9292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EVANGELICAL HOMES OF MICHIGAN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center