Southfield Alternative Care Clinic

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

LB008193 Issued in MI

Legal business name

SOUTHFIELD ALTERNATIVE CARE CLINIC

Practice address

30500 Northwestern Hwy Ste 316B
Farmington Hills, MI 48334-3159

Phone

(248) 258-6842

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Lazar Berkovich

Title

Owner

Phone

(248) 258-6842

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790792364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30500 NORTHWESTERN HWY STE 316B",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30500 NORTHWESTERN HWY STE 316B",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343159",
            "telephone_number": "248-258-6842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHFIELD ALTERNATIVE CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERKOVICH",
        "authorized_official_first_name": "LAZAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-258-6842"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "LB008193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4237430",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mellinda Soupis
• Cathleen Souryasak
• Kenneth South
• Maxwell L Southam
• Erin Southards
• Cecelia Southward
• Aaron Southwell
• Amy Southwood
• Joan C. Southworth
• Micaela Souza

• Chiropractor in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.