Whalio Doctors

NPI 1477639458

Vista Maria

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Dearborn Heights, MI

Practice location

Address
20651 W Warren Ave, Dearborn Heights, MI 48127-2622
Phone
(313) 271-3050
Fax
(313) 336-3460
Mailing address
20651 W Warren St, Dearborn Heights, MI 48127-2622

Authorised official

Name
Earl Goddin
Title
Chief Financial Officer
Phone
(313) 271-3050

Registered specialties (4)

Emotionally Disturbed Childrens' Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 322D00000X Licence 43 01 070436 (MI)
Emotionally Disturbed Childrens' Residential Treatment Facility
Residential Treatment Facilities Taxonomy 322D00000X Licence 43 01 052026 (MI)
Emotionally Disturbed Childrens' Residential Treatment Facility
Residential Treatment Facilities Taxonomy 322D00000X Licence 43 01 032319 (MI)
Emotionally Disturbed Childrens' Residential Treatment Facility
Residential Treatment Facilities Taxonomy 322D00000X Licence 43 01 036786 (MI)

Registry record

NPI
1477639458
Entity type
Organization
NPI issued
31 Oct 2006
Record last updated
7 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.