Provider Demographics
NPI:1215058300
Name:MEAHAN THERAPY INC
Entity type:Organization
Organization Name:MEAHAN THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MEAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:734-416-3341
Mailing Address - Street 1:1951 S GLOBE ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-3930
Mailing Address - Country:US
Mailing Address - Phone:734-417-3341
Mailing Address - Fax:
Practice Address - Street 1:190 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1236
Practice Address - Country:US
Practice Address - Phone:734-416-3341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010599891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8008954890OtherBLUE CROSS
MI8008954890OtherBLUE CROSS
MI8008954890OtherBLUE CROSS