Modern Health Connections LLC

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

Legal business name

MODERN HEALTH CONNECTIONS LLC

Practice address

11383 Mark Twain St
Detroit, MI 48227-3051

Phone

(313) 506-5739

NPI assigned

Feb 10, 2022

Last updated

Jul 2, 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

Amir Bracken, SST

Title

Owner

Phone

(313) 377-2018

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656720000000",
    "number": "1558015255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11383 MARK TWAIN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482273051",
            "telephone_number": "313-506-5739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11383 MARK TWAIN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482273051",
            "telephone_number": "313-506-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN HEALTH CONNECTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A",
        "authorized_official_last_name": "BRACKEN",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-377-2018",
        "authorized_official_credential": "SST"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mobility Plus Specialist
• Mobley Express LLC
• Douglas Michael Mobley
• Latoya Marie Mobley, B.S LSST
• Joseph Moch
• Dipenkumar Kanaiyalal Modi, M.D.
• Nili Modi, MD
• Joshua Michael Modrick, DO
• Ashish M Mody, M.D.
• Anzor Modzgvreschvili, RD

• Adolescent and Children Mental Health Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• Adolescent and Children Mental Health Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.