Organization
THE WELLNESS PLAN MEDICAL CENTERS
Active
Parent organization
THE WELLNESS PLAN MEDICAL CENTERS
Other names
The Wellness Plan-Keys Grace Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE WELLNESS PLAN MEDICAL CENTERS
Authorized official
SHERRI ATWATER (COMPLIANCE AND CREDENTIALING)
(313) 202-8500
Entity
Organization
Contact information
Practice address
27321 HAMPDEN ST RM 202, MADISON HEIGHTS, MI 48071-3113
(313) 202-8660
Mailing address
7700 2ND AVE, DETROIT, MI 48202-2411
(313) 202-8660
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0M37210
—
MI
Enumeration date
03/14/2018
Last updated
07/30/2019
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