Provider Demographics
NPI:1336296946
Name:IHA HEALTH SERVICES CORPORATION
Entity Type:Organization
Organization Name:IHA HEALTH SERVICES CORPORATION
Other - Org Name:HURON VALLEY CT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP / CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-747-6766
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DR
Mailing Address - Street 2:PO BOX 0446 LOBBY J
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9484
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4990 W CLARK RD
Practice Address - Street 2:SUITE 300
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1149
Practice Address - Country:US
Practice Address - Phone:734-434-0539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty