Provider Demographics
NPI:1306383252
Name:TEAM MENTAL HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:TEAM MENTAL HEALTH SERVICES INC.
Other - Org Name:TEAM WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLICELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-274-3700
Mailing Address - Street 1:290 TOWN CENTER DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-2739
Mailing Address - Country:US
Mailing Address - Phone:313-274-3700
Mailing Address - Fax:313-274-4900
Practice Address - Street 1:3646 MOUNT ELLIOTT ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-2311
Practice Address - Country:US
Practice Address - Phone:313-626-2400
Practice Address - Fax:313-921-4125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty