| Organization Name: | MAIN STREET MEDICAL & COUNSELING CENTER PLC |
| NPI Number: | 1851711642 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MITCHELL DENNIS GOLDMAN (OWNER) |
| Mailing Address: | 103 E. Main St. Pinckney |
| State: | MI US |
| Postal Code: | 48169 |
| Phone Number: | 7344741525 |
| Fax Number: | 7348785103 |
| NPI Enumeration Date: | 04/21/2014 |
| NPI Last Update Date: | 02/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 4301083561 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |