Panagia Medical Recovery Clinic PLLC

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

Legal business name

PANAGIA MEDICAL RECOVERY CLINIC PLLC

Practice address

43191 Dalcoma Dr Ste 101
Clinton Township, MI 48038-6308

Phone

(248) 810-4727

Fax

(248) 810-4727

NPI assigned

Mar 24, 2026

Organization subpart

No

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

Authorized official

Name

Dr. Mira Grace, MDNPI 1659667293

Title

Member

Phone

(248) 810-4727

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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

• Mira Grace, MD

  • Addiction Medicine (Family Medicine) Physician
  • Clinton Township, MI
  • NPI 1659667293
  Medicare reassignment NPD Authorized official
• Charles Moheb Yanni, M.D.

  • Family Medicine Physician
  • Ann Arbor, MI
  • NPI 1477864080

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1774310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1801734249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43191 DALCOMA DR STE 101",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386308",
            "telephone_number": "248-810-4727",
            "fax_number": "248-810-4727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43191 DALCOMA DR STE 101",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386308",
            "telephone_number": "248-810-4727",
            "fax_number": "248-810-4727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANAGIA MEDICAL RECOVERY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "GRACE",
        "authorized_official_first_name": "MIRA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "248-810-4727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Painter
• Angela Kathryn Palimino, M.A., LLPC, BCBA
• Nikolette Palmer, PT, DPT
• Samanta Palomar-Salcedo, LPC
• Guodong Pan, MD
• Adrienne Pandori
• Shannon McDermott Panetta, PHD LLP
• Susha Thomas Panicker, PMHNP-BC, FNP-BC
• Andrew C Pankiewicz, BEHAVIOR TECHNICIAN
• Jennifer Ann Pantaleo Hagle

• Addiction Medicine (Family Medicine) Physician in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Addiction Medicine (Family Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.