Provider Demographics
NPI:1710213707
Name:Y-PCS GROUP
Entity Type:Organization
Organization Name:Y-PCS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDER
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:TRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-412-1318
Mailing Address - Street 1:8499 WAHRMAN ST
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-4161
Mailing Address - Country:US
Mailing Address - Phone:313-412-1318
Mailing Address - Fax:734-895-3809
Practice Address - Street 1:8499 WAHRMAN ST
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-4161
Practice Address - Country:US
Practice Address - Phone:313-412-1318
Practice Address - Fax:734-895-3809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service