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Contact Information

BANYAN SOBER LIVING OF MICHIGAN
1023 WASHTENAW RD
YPSILANTI, MI48197-2161
 Phone: 231-233-8474
 Fax: 734-264-0732
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Medical Laboratory

291U00000X 69 Clinical Laboratory
Indicates primary specialty

NPI Profile & details for BANYAN SOBER LIVING OF MICHIGAN

NPI # 1245650035
LBN Legal business name BANYAN SOBER LIVING OF MICHIGAN
Authorized official MACKENZIE KOONCE - (COO)
Entity Organization
Organization subpart 1 No
Enumeration date 04/21/2014
Last updated 04/21/2014 - About 12 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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