Pace Southeast Michigan

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

PACE SOUTHEAST MICHIGAN

Practice address

17401 E 10 Mile Rd
Eastpointe, MI 48021-1256

Phone

(855) 445-4554

NPI assigned

Jun 24, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bryan Dovichi

Title

Program Director

Phone

(313) 269-7744

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tynese E Vinson, LCSW

  • Clinical Social Worker
  • Columbia, SC
  • NPI 1598294662
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1003485830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21700 NORTHWESTERN HWY",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754906",
            "telephone_number": "855-445-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17401 E 10 MILE RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480211256",
            "telephone_number": "855-445-4554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACE SOUTHEAST MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-24",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "DOVICHI",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "313-269-7744"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "WARREN",
            "affiliation": "N",
            "endpointDescription": "EPIC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "17401 E 10 Mile Rd",
            "city": "Eastpointe",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480211256",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Optometry PC
• Our Parents Adult Day Treatment LLC
• Our Wellness Hub
• Oxford Optical Co
• Navdeep Kaur Pabla, RN BSN MSN NP-C
• Stephen James Palajac, DPM
• Katherine Anne Paquette, ACNP
• Monica Lynn Parham-Contejean, RD
• Natasha Christina Paris
• Haeri Park, DMD

• Developmentally Disabled Services Day Training Agency in Eastpointe, MI
• Providers in Eastpointe, MI by specialty
• Developmentally Disabled Services Day Training Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.