Provider Demographics
NPI:1245418151
Name:OAKWOOD HEALTHCARE GROUP II, LLC
Entity Type:Organization
Organization Name:OAKWOOD HEALTHCARE GROUP II, LLC
Other - Org Name:OAKWOOD TEEN CENTERS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:947-522-3338
Mailing Address - Street 1:26901 BEAUMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1963
Mailing Address - Fax:
Practice Address - Street 1:26650 EUREKA RD STE B
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-4835
Practice Address - Country:US
Practice Address - Phone:734-286-1066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1699754226OtherNPI
MI1386624591OtherNPI
MI1891765327OtherNPI
MI1083708200OtherNPI
MI1831191576OtherNPI
MI080H221710OtherB.C.B.S. MI
MI500H201890OtherBLUE CROSSBLUE SHIELD MI
MI1245237551OtherNPI
MI1326019076OtherNPI
MI1578500724OtherNPI
MI1548307945OtherNPI
MI1861462632OtherNPI