NPIMap

Organization Active NPI

Michigan Forensic Intervention Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Saint Clair Shores, MI
National Provider Identifier
1861862641
Registry record updated Oct 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
SA0500473 Issued in MI
Legal business name
MICHIGAN FORENSIC INTERVENTION SERVICES
Practice address
21821 Lakeview St
Saint Clair Shores, MI 48080-4057
Phone
(586) 945-8034
NPI assigned
Oct 6, 2015
Last updated
Oct 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2015

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

Authorized official

Name
Victoria Marion
Title
Mental Health Counselor
Phone
(586) 945-8034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X SA0500473 MI Primary

Addresses

Primary practice location

21821 Lakeview St
Saint Clair Shores, MI 48080-4057

Mailing address

21821 Lakeview St
Saint Clair Shores, MI 48080-4057

National Provider Directory

National Provider Directory
Tax ID family
Ihealth LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1861862641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21821 LAKEVIEW ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480804057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21821 LAKEVIEW ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480804057",
            "telephone_number": "586-945-8034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN FORENSIC INTERVENTION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "MARION",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "586-945-8034"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MI",
            "license": "SA0500473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.