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CHILD AND ADOLESCENT CENTER P C
NPI 1952498875
Pediatrics in Southgate, MI

Active since October 10, 2006CLIA 23D0369176 · Waiver
15350 TRENTON RD, SOUTHGATE, MI 48195(734) 283-4616(734) 283-5430 Get Directions Write a Review

NPPES record last updated: December 13, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Child And Adolescent Center P C NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHILD AND ADOLESCENT CENTER P C (NPI 1952498875) is a healthcare organization registered as a pediatrics in Southgate, Michigan and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through October 16, 2027 and lists Paula Green, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1952498875
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameCHILD AND ADOLESCENT CENTER P C
Location Address15350 TRENTON RDSouthgate, MI 48195-2027
Mailing Address15350 Trenton RdSouthgate, MI 48195-2027 · (734) 283-4616 · Fax (734) 283-5430
Phone(734) 283-4616
Fax(734) 283-5430
Organization SubpartNo
Authorized OfficialPaula GreenOffice Manager · (734) 283-4616
Enumeration DateOctober 10, 2006
Last NPPES UpdateDecember 13, 2011
✔ NPI 1952498875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
15350 TRENTON RD, Southgate, MI 48195
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Other Identifiers 1

Other350H27736MI · Bcbsm Provider Id Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D0369176

Child & Adolescent Center, P C · Southgate, MI
Active · expires Oct 16, 2027
CLIA Number23D0369176
Laboratory TypePhysician Office
Certificate Effective DateOctober 17, 2025
Certificate Expiration DateOctober 16, 2027
Laboratory DirectorSaba R. Cossor
Laboratory Phone(734) 283-4616
Laboratory LocationChild & Adolescent Center, P C15350 Trenton Rd, Southgate, MI 48195
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAITLIN DUGHLAS CPNP-PC
Nurse Practitioner (Pediatrics)
15350 TRENTON RD
SOUTHGATE, MI 48195
Wayne County (734) 283-4616
JASON WILLIAM BIHN M.D.
Pediatrics
15350 TRENTON RD
SOUTHGATE, MI 48195
Wayne County (734) 283-4616
AMANDA LAUREN BOWMAN- COLLINS PA-C
Physician Assistant
15350 TRENTON RD
SOUTHGATE, MI 48195
Wayne County (734) 283-4616
DR. JURIN BORIBOON M.D.
Pediatrics
15350 TRENTON RD
SOUTHGATE, MI 48195
Wayne County (734) 283-4616
DR. PETRONIO C YADAO M.D.
Pediatrics
15350 TRENTON RD
SOUTHGATE, MI 48195
Wayne County (734) 283-4616
ALEXANDRA PATRICE ST ONGE DO
Pediatrics
15350 TRENTON RD
SOUTHGATE, MI 48195
Wayne County (734) 283-4616
DR. SABA RAISA COSSOR M.D.
Pediatrics
15350 TRENTON RD
SOUTHGATE, MI 48195
Wayne County (734) 283-4616
DR. YONG S KIM M.D.
Pediatrics
15350 TRENTON RD
SOUTHGATE, MI 48195
Wayne County (734) 283-4616

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Child And Adolescent Center P C's NPI number?

The NPI number for Child And Adolescent Center P C is 1952498875. It was assigned to this organization in the NPPES registry on October 10, 2006.

Where is Child And Adolescent Center P C located?

Child And Adolescent Center P C is located at 15350 Trenton Rd, Southgate, MI 48195. The listed phone number is (734) 283-4616.

What is Child And Adolescent Center P C's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Child And Adolescent Center P C hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D0369176) is associated with this NPI, valid through October 16, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Child And Adolescent Center P C accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Blue Cross Blue Shield of Michigan Mutual Insurance Company list Child And Adolescent Center P C as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Child And Adolescent Center P C was last updated on December 13, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.