Moriah Enrichment Center, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

MORIAH ENRICHMENT CENTER, LLC

Practice address

8735 Mi State Road 52
Manchester, MI 48158-9445

Phone

(734) 428-0369

Fax

(734) 428-0408

NPI assigned

Jun 11, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Charles Trojanek

Title

Director of Finance

Phone

(734) 677-0070

Specialties & licenses 7

Addresses

Practitioners 1

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

• Garrett Michael Bryan, BEHAVIOR TECH

  • Behavior Technician
  • Jackson, MI
  • NPI 1376359364
  NPD (past)

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658448000000",
    "number": "1730757261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481066069",
            "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": "8735 MI STATE ROAD 52",
            "city": "MANCHESTER",
            "state": "MI",
            "postal_code": "481589445",
            "telephone_number": "734-428-0369",
            "fax_number": "734-428-0408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8737 M 52",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "MI",
            "postal_code": "481589445",
            "country_code": "US",
            "telephone_number": "734-428-0369",
            "fax_number": "734-428-0408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MORIAH ENRICHMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-11",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A",
        "authorized_official_last_name": "TROJANEK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "734-677-0070",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manchester Eye Care Center, P.C.
• Julie A Marvin-Manders, O.D.
• Katherine Ann McClure, MSW, LMSW
• Pamela Sue McClure, M.A. CCC-SLP
• Leo Vasserot Merle VI, DDS
• Peaceful Mind Counseling Services LLC
• Rap Teletherapy PLLC
• Erica Rush, MD
• Debora Spring
• William Stahly

• All providers in Manchester, MI
• Multi-Specialty Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.