Basic Information
Provider Information
NPI: 1356987762
EntityType: 2
ReplacementNPI:  
OrganizationName: LINCOLN BEHAVIORAL SERVICES
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Mailing Information
Address1: 9315 TELEGRAPH RD
Address2:  
City: REDFORD
State: MI
PostalCode: 482391260
CountryCode: US
TelephoneNumber: 3134504500
FaxNumber: 3134504514
Practice Location
Address1: 9315 TELEGRAPH RD
Address2:  
City: REDFORD
State: MI
PostalCode: 482391260
CountryCode: US
TelephoneNumber: 3134504500
FaxNumber: 3134504514
Other Information
ProviderEnumerationDate: 11/20/2019
LastUpdateDate: 11/20/2019
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: QUATES
AuthorizedOfficialFirstName: MARIE
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AuthorizedOfficialTitleorPosition: REIMBURSEMENT SPECIALIST
AuthorizedOfficialTelephone: 3134504500
IsSoleProprietor:  
IsOrganizationSubpart: N
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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