Organization · NPI-2

1/4 Mile Recovery, PLLC

Psychiatry & Neurology, Psychiatry · Farmington Hills, MI

NPI number1477018372
StatusActive
Last updated in NPPESFeb 5, 2019

Details

NPI
1477018372
Entity type
Organization (NPI-2)
Legal business name
1/4 Mile Recovery, PLLC
Organization subpart
No
Enumeration date
Feb 5, 2019
Last updated
Feb 5, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084P0800X Psychiatry & Neurology, Psychiatry––Yes
1041C0700X Social Worker, Clinical––

Practice location

30300 Northwestern Hwy Ste 290
Farmington Hills, MI 48334-3476

Phone 248-671-4116

Mailing address

1281 E 14 Mile Rd
Birmingham, MI 48009-2090

Authorized official

Ruma Hopkins
Member
2483030391

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