Provider Demographics
NPI:1689485658
Name:ZION HEALING CENTERS MI LLC
Entity type:Organization
Organization Name:ZION HEALING CENTERS MI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:IP
Authorized Official - Suffix:
Authorized Official - Credentials:TLLP
Authorized Official - Phone:586-764-5668
Mailing Address - Street 1:43777 N GROESBECK HWY
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-1112
Mailing Address - Country:US
Mailing Address - Phone:586-899-8484
Mailing Address - Fax:
Practice Address - Street 1:43777 N GROESBECK HWY
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-1112
Practice Address - Country:US
Practice Address - Phone:586-899-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center