Provider Demographics
NPI:1073334249
Name:VETERAN HEROES HEALTHCARE CENTER OF MICHIGAN
Entity type:Organization
Organization Name:VETERAN HEROES HEALTHCARE CENTER OF MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/HEALTHCARE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-277-7828
Mailing Address - Street 1:25559 SHIAWASSEE RD APT 521
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033
Mailing Address - Country:US
Mailing Address - Phone:623-277-7828
Mailing Address - Fax:
Practice Address - Street 1:25559 SHIAWASSEE RD APT 521
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033
Practice Address - Country:US
Practice Address - Phone:623-277-7828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QV0200XAmbulatory Health Care FacilitiesClinic/CenterVA
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty