Provider Demographics
NPI:1871767350
Name:PRIMACARE MENTAL HEALTH & CONSULTATION
Entity type:Organization
Organization Name:PRIMACARE MENTAL HEALTH & CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZZO
Authorized Official - Suffix:II
Authorized Official - Credentials:PHD, PP
Authorized Official - Phone:734-513-1122
Mailing Address - Street 1:28303 JOY ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185
Mailing Address - Country:US
Mailing Address - Phone:737-513-1122
Mailing Address - Fax:734-421-1405
Practice Address - Street 1:28303 JOY RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-5524
Practice Address - Country:US
Practice Address - Phone:734-513-1122
Practice Address - Fax:734-421-1405
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPECTRUM HUMAN SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801018844261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health