1477694925 NPI number — HEGIRA HEALTH, INC

Table of content: (NPI 1477694925)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477694925 NPI number — HEGIRA HEALTH, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEGIRA HEALTH, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMMUNITY OUTREACH FOR PSYCHIATRIC EMERGENCIES
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477694925
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
37450 SCHOOLCRAFT RD STE 110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIVONIA
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48150-1000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-458-4601
Provider Business Mailing Address Fax Number:
734-458-4611

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33505 SCHOOLCRAFT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVONIA
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48150-1630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-721-0200
Provider Business Practice Location Address Fax Number:
734-838-0085
Provider Enumeration Date:
02/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ZUNIGA
Authorized Official First Name:
CAROL
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
734-499-1513

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM0801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3119549 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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