# BEAUMONT WEIGHT CONTROL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326186685
- **Authorized official:** LEE ANN ODOM (PRESIDENT SHARED SERVICES)
- **Authorized official phone:** (947) 522-3326

## Contact information

- **Practice address:** 4949 COOLIDGE HWY, ROYAL OAK, MI 48073-1026
- **Practice address phone:** (248) 655-5900
- **Practice address fax:** (248) 655-5901
- **Mailing address:** 26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
- **Mailing address phone:** (947) 522-1964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/01/2007
- **Last updated:** 10/01/2021