Edm Treatment Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EDM TREATMENT CENTER

Practice address

3605 Davenport Ave
Ste 205
Saginaw, MI 48602-3310

Phone

(989) 401-1440

Fax

(866) 466-7892

NPI assigned

Dec 18, 2007

Last updated

Nov 7, 2016By 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

Steven Shia Clark, LMSW

Title

Owner

Phone

(989) 401-1440

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1942484647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 DAVENPORT AVE",
            "address_2": "STE. 205",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486023310",
            "telephone_number": "989-401-1440",
            "fax_number": "866-466-7892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 DAVENPORT AVE",
            "address_2": "STE 205",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486023310",
            "telephone_number": "989-401-1440",
            "fax_number": "866-466-7892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDM TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "SHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-401-1440",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Community/Behavioral Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.