Provider Demographics
NPI:1346998358
Name:ZBAHA PSYCHIATRIC SERVICES PLC
Entity Type:Organization
Organization Name:ZBAHA PSYCHIATRIC SERVICES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZAID
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-508-2153
Mailing Address - Street 1:PO BOX 20207
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-0207
Mailing Address - Country:US
Mailing Address - Phone:702-508-2153
Mailing Address - Fax:702-508-2435
Practice Address - Street 1:1117 GRISWOLD ST UNIT 1514
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48226-1937
Practice Address - Country:US
Practice Address - Phone:702-508-2153
Practice Address - Fax:702-508-2435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1447604608Medicaid