Provider Demographics
NPI:1942744677
Name:GROVE EMOTIONAL HEALTH COLLABORATIVE
Entity Type:Organization
Organization Name:GROVE EMOTIONAL HEALTH COLLABORATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-224-3822
Mailing Address - Street 1:214 S MAIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2122
Mailing Address - Country:US
Mailing Address - Phone:734-224-3822
Mailing Address - Fax:888-881-8415
Practice Address - Street 1:214 S MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2122
Practice Address - Country:US
Practice Address - Phone:734-224-3822
Practice Address - Fax:888-881-8415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010939381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty