1528687498 NPI number — OXFORD RECOVERY CENTER

Table of content: DR. WILLIAM CLAY CHURCH DDS (NPI 1316376163)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528687498 NPI number — OXFORD RECOVERY CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OXFORD RECOVERY CENTER
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:
Provider Other Organization Name Type Code:
6
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:
1528687498
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7030 WHITMORE LAKE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIGHTON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48116-8533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-486-3636
Provider Business Mailing Address Fax Number:
248-486-0686

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7015 FIELDCREST DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRIGHTON
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48116-8414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-486-3636
Provider Business Practice Location Address Fax Number:
248-486-0686
Provider Enumeration Date:
04/10/2020

Additional Information

Authorized Official

Authorized Official Last Name:
OXFORD
Authorized Official First Name:
BLAKE
Authorized Official Middle Name:
P
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
248-486-3636

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1-17-28259 . This is a "BEHAVIORAL ANALYST CERTIFICATION BOARD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1-18-31159 . This is a "BEHAVIORAL ANALYST CERTIFICATION BOARD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1-17-26089 . This is a "BEHAVIORAL ANALYST CERTIFICATION BOARD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1-20-41379 . This is a "BEHAVIORAL ANALYST CERTIFICATION BOARD" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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