Provider Demographics
NPI:1831850965
Name:MILETIC INSTITUTE FOR INTEGRATED HEALTH PLLC
Entity type:Organization
Organization Name:MILETIC INSTITUTE FOR INTEGRATED HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-320-3900
Mailing Address - Street 1:36800 WOODWARD AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-0916
Mailing Address - Country:US
Mailing Address - Phone:248-593-8540
Mailing Address - Fax:248-792-0605
Practice Address - Street 1:36800 WOODWARD AVE STE 112
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-0916
Practice Address - Country:US
Practice Address - Phone:248-593-8540
Practice Address - Fax:248-792-0605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty