Organization
COMMON GROUND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY SUZANNE PRELLBERG RN (REGISTERED NURSE)
(248) 554-5818
Entity
Organization
Contact information
Practice address
1410 TELEGRAPH ROAD, PONTIAC, MI 48332
(248) 341-3780
Mailing address
34971 AQUARIUS DR, STERLING HEIGHTS, MI 48310-5633
(248) 554-5818
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
4704298086
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1111111
—
MI
05
—
2222222
—
MI
Enumeration date
01/24/2014
Last updated
01/24/2014
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