Provider Demographics
NPI:1780183400
Name:SPINE & HEALTH LLC
Entity Type:Organization
Organization Name:SPINE & HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FAYAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-888-2333
Mailing Address - Street 1:15565 NORTHLAND DR W
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5303
Mailing Address - Country:US
Mailing Address - Phone:248-809-3631
Mailing Address - Fax:248-864-8992
Practice Address - Street 1:15565 NORTHLAND DR W
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5303
Practice Address - Country:US
Practice Address - Phone:248-809-3631
Practice Address - Fax:248-864-8992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain