Provider Demographics
NPI:1275970709
Name:MCKENARLD TREATMENT CENTER, IN.
Entity Type:Organization
Organization Name:MCKENARLD TREATMENT CENTER, IN.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:IKE
Authorized Official - Last Name:ONWUEMELIE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CAADC
Authorized Official - Phone:313-532-4604
Mailing Address - Street 1:24801 5 MILE RD
Mailing Address - Street 2:SUITE 19
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-3655
Mailing Address - Country:US
Mailing Address - Phone:313-532-4604
Mailing Address - Fax:313-532-4608
Practice Address - Street 1:24801 5 MILE RD
Practice Address - Street 2:SUITE 19
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3655
Practice Address - Country:US
Practice Address - Phone:313-532-4604
Practice Address - Fax:313-532-4608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)