Active NPI
Team Mental Health Services, Inc
- Primary Care Clinic/Center
- Detroit, MI
National Provider Identifier
1851796734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- TEAM MENTAL HEALTH SERVICES, INC
- Practice address
- 2925 Russell St
Detroit, MI 48207-4825 - Phone
- (313) 396-5300
- Fax
- (313) 274-4900
- NPI assigned
- Nov 4, 2014
- Last updated
- Jan 30, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Antonio Pollicella
- Title
- Ceo
- Phone
- (313) 274-3700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | NU | Primary |
Addresses
Primary practice location
2925 Russell St
Detroit, MI 48207-4825
Mailing address
290 Town Center Dr
Dearborn, MI 48126-2739
Phone (313) 274-3700
Other practice location 1
6309 Mack Ave
Detroit, MI 48207-2302
Phone (313) 331-3435
Other practice location 2
14799 Dix Toledo Rd
Southgate, MI 48195-2507
Phone (734) 324-8326
Other practice location 3
34290 Ford Rd
Westland, MI 48185-3051
Phone (734) 412-8800
Other practice location 4
11105 E Jefferson Ave
Detroit, MI 48214-3317
Phone (313) 396-5300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4695337 | Medicaid | MI |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D2040953 | Team Mental Health Services | Certificate of waiver | May 14, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Team Mental Health Services Inc
Other organizations with this tax ID 7
Organizations that report the same tax identification number in the National Provider Directory.
-
- Case Management Agency
- Detroit, MI
- NPI 1295139830
-
dba Team Wellness Center
- Urgent Care Clinic/Center
- Detroit, MI
- NPI 1144794892
-
dba Team Wellness Center
- Primary Care Clinic/Center
- Detroit, MI
- NPI 1295324291
-
- Community/Behavioral Health Agency
- Southgate, MI
- NPI 1417315466
-
- Health Maintenance Organization
- Detroit, MI
- NPI 1467817098
-
- Case Management Agency
- Detroit, MI
- NPI 1770966368
Locations
290 Town Center Dr
Dearborn, MI 48126
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415059200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1675036800000",
"number": "1851796734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 TOWN CENTER DR",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481262739",
"telephone_number": "313-274-3700",
"fax_number": "313-274-4900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2925 RUSSELL ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482074825",
"telephone_number": "313-396-5300",
"fax_number": "313-274-4900"
}
],
"practiceLocations": [
{
"address_1": "6309 Mack Ave",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482072302",
"country_code": "US",
"telephone_number": "313-331-3435",
"fax_number": "313-274-4900",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "14799 Dix Toledo Rd",
"address_purpose": "LOCATION",
"city": "Southgate",
"state": "MI",
"postal_code": "481952507",
"country_code": "US",
"telephone_number": "734-324-8326",
"fax_number": "313-274-4900",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "34290 Ford Rd",
"address_purpose": "LOCATION",
"city": "Westland",
"state": "MI",
"postal_code": "481853051",
"country_code": "US",
"telephone_number": "734-412-8800",
"fax_number": "313-274-4900",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11105 E Jefferson Ave",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482143317",
"country_code": "US",
"telephone_number": "313-396-5300",
"fax_number": "313-274-4900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "TEAM MENTAL HEALTH SERVICES, INC",
"organizational_subpart": "NO",
"enumeration_date": "2014-11-04",
"last_updated": "2023-01-30",
"certification_date": "2023-01-30",
"status": "A",
"authorized_official_last_name": "POLLICELLA",
"authorized_official_first_name": "ANTONIO",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "313-274-3700"
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4695337",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
- Team Cares Pharmacy LLC (Team Cares Pharmacy)
- 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 Veteran,LLC
- Team Wellness Center
- Team Wellness Center
- Team Wellness Center
- Team Wellness Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.