Provider Demographics
NPI:1497760086
Name:HEALTHCALL OF DETROIT
Entity Type:Organization
Organization Name:HEALTHCALL OF DETROIT
Other - Org Name:HEALTHCALL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:MERRITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-440-1496
Mailing Address - Street 1:28000 WOODWARD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-0960
Mailing Address - Country:US
Mailing Address - Phone:248-395-3777
Mailing Address - Fax:248-395-3370
Practice Address - Street 1:28000 WOODWARD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-0960
Practice Address - Country:US
Practice Address - Phone:248-395-3777
Practice Address - Fax:248-395-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 106S00000X, 2080P0006X
MIN/A251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing CareGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F31852OtherBLUE CROSS BLUE SHIELD MI
MI1815923Medicaid
MI4359764Medicaid
MI4359764Medicaid