Moriah, Incorporated

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MORIAH, INCORPORATED

Practice address

29991 Mitchell St
Selfridge Angb, MI 48045-4957

Phone

(734) 677-0070

Fax

(734) 677-0890

NPI assigned

Jun 14, 2021

Organization subpart

Yes

Parent organization

MORIAH INC.As reported in NPPES

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

Authorized official

Name

Tim Mucha, MHA

Title

Compliance and Contracts Manager

Phone

(734) 677-0070

Specialties & licenses 3

Addresses

Other names 1

• Eisenhower Veterans Reintegration Center Other name

Tax ID family

Moriah Incorporated4 organizations share this tax ID, including this one

Part of

Moriah Incorporated

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Moriah, Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ann Arbor, MI
  • NPI 1558544130
  NPD tax ID
• Moriah, Incorporated

  • Developmental Disabilities Clinic/Center
  • Ann Arbor, MI
  • NPI 1982272365
  NPD tax ID
• Moriah, Incorporated

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ann Arbor, MI
  • NPI 1992308977
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Moriah, Incorporated

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ann Arbor, MI
  • NPI 1558544130
  NPPES parent name

Practitioners 2

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

• Lauri Ann McVeigh, LPC

  • Professional Counselor
  • Grosse Pointe Farms, MI
  • NPI 1760659304
  NPD (past)
• Tina Marie Wheeler, M.S., L.L.P.

  • Family Psychologist
  • Garden City, MI
  • NPI 1467624593
  NPD (past)

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1013585405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 E EISENHOWER PKWY",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481083231",
            "telephone_number": "734-677-0070",
            "fax_number": "734-677-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29991 MITCHELL ST",
            "city": "SELFRIDGE ANGB",
            "state": "MI",
            "postal_code": "480454957",
            "telephone_number": "734-677-0070",
            "fax_number": "734-677-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MORIAH, INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MORIAH INC.",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "MUCHA",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "COMPLIANCE AND CONTRACTS MANAGER",
        "authorized_official_telephone_number": "734-677-0070",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eisenhower Veterans Reintegration Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Isabelle R Doherty
• Andrea Lindsay Hodges, LLMSW
• Brandon Charles Holda
• Diana Lee Kott, RDH
• Dana Marie Kubinski, RDH
• Uscg Clinic Sector Detroit

• Multi-Specialty Clinic/Center in Selfridge Angb, MI
• Providers in Selfridge Angb, MI by specialty
• Multi-Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.