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Organization

SCOTT CORRECTIONL FACILITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ARUNA BAVINENI MD (STAFF PSYCHIATRIST)
(734) 459-7400
Entity
Organization

Contact information

Practice address
47500 FIVE MILE RD, PLYMOUTH, MI 48170-2487
(734) 459-7400
Mailing address
3425 CHEROKEE TRL, YPSILANTI, MI 48198-9498
(734) 481-0239

Taxonomy

Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
4301059562
MI

Other

Enumeration date
07/26/2006
Last updated
07/13/2007
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