Midwest Detox LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

MIDWEST DETOX LLC

Practice address

31153 Plymouth Rd Ste 105
Livonia, MI 48150-2134

Phone

(231) 409-0606

NPI assigned

Jan 26, 2022

Last updated

Jan 26, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donovan Miske

Title

Executive Director

Phone

(313) 444-0167

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1316690753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31153 PLYMOUTH RD STE 105",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31153 PLYMOUTH RD STE 105",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481502134",
            "telephone_number": "231-409-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST DETOX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "MISKE",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "313-444-0167"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mid State Care Services LLC
• Mid State Vocational Rehabilitation Services LLC
• Middlebelt Community Pharmacy LLC
• Middlebelt Medical Center, PLC
• Middlebelt-Hope Acquisition Company, Inc. (Regency at Livonia)
• Midwest Health Center of Livonic, P.C.
• Midwest Health Center-Livonia
• Midwest Physical Medicine and Rehabilitation PLLC
• Erica Mifsud
• Michael Migliore, MM, BC-MT

• Addiction (Substance Use Disorder) Counselor in Livonia, MI
• Providers in Livonia, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.