Provider Demographics
NPI:1659693547
Name:RAMOS, CARMEN (BS)
Entity Type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15170 PAYNE CT
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126-3087
Mailing Address - Country:US
Mailing Address - Phone:313-581-7501
Mailing Address - Fax:734-451-5410
Practice Address - Street 1:8142 HONEYTREE BLVD
Practice Address - Street 2:BLDG. 61
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4109
Practice Address - Country:US
Practice Address - Phone:734-414-1795
Practice Address - Fax:734-451-5410
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility