Provider Demographics
NPI:1457517682
Name:PSYCHIATRIC SUPPORT SERVICES, PLLC
Entity Type:Organization
Organization Name:PSYCHIATRIC SUPPORT SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-471-7171
Mailing Address - Street 1:20010 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1408
Mailing Address - Country:US
Mailing Address - Phone:248-471-7171
Mailing Address - Fax:248-471-1212
Practice Address - Street 1:20010 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1408
Practice Address - Country:US
Practice Address - Phone:248-471-7171
Practice Address - Fax:248-471-1212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)