Team Veteran,LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

TEAM VETERAN,LLC

Practice address

19135 Van Dyke St
Detroit, MI 48234-3347

Phone

(313) 412-5053

Fax

(313) 412-5053

NPI assigned

May 5, 2020

Last updated

May 5, 2020By 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

Tracy Vivian KirbyNPI 1205673647

Title

Operational Manager

Phone

(313) 412-5053

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tracy Vivian Kirby

  • Health Educator
  • Ann Arbor, MI
  • NPI 1205673647
  NPD Authorized official

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588636800000",
    "number": "1811518418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66074",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480666074",
            "telephone_number": "313-739-7982",
            "fax_number": "313-412-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19135 VAN DYKE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482343347",
            "telephone_number": "313-412-5053",
            "fax_number": "313-412-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAM VETERAN,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A",
        "authorized_official_last_name": "KIRBY",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "VIVIAN",
        "authorized_official_title_or_position": "OPERATIONAL MANAGER",
        "authorized_official_telephone_number": "313-412-5053"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Team Mental Health
• Team Mental Health Services Inc. (Team Wellness Center)
• Team Mental Health Services Inc. (Team Wellness Center)
• Team Mental Health Services Inc. (Team Wellness Center)
• Team Mental Health Services, Inc
• Team Wellness Center
• Team Wellness Center
• Team Wellness Center
• Team Wellness Center
• Magdalene Tikun Teba, MD

• Home Health Agency in Detroit, MI
• Providers in Detroit, MI by specialty
• Home Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.