Organization
J&E PICKENS FAMILY,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D PICKENS (OWNER)
(734) 992-7212
Entity
Organization
Contact information
Practice address
39245 NOTTINGHAM ST, WESTLAND, MI 48186-3729
(734) 992-7212
(734) 629-4773
Mailing address
39245 NOTTINGHAM ST, WESTLAND, MI 48186-3729
(734) 992-7212
(734) 629-4773
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497294805.
—
MI
Enumeration date
02/17/2017
Last updated
05/12/2017
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