Organization Name: | THERAPEUTICS, LLC |
NPI Number: | 1902284193 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEIDRE VIAN GOLDSMITH (PROGRAM DIRECTOR) |
Mailing Address: | 50222 Dennis Ct Wixom |
State: | MI US |
Postal Code: | 483932023 |
Phone Number: | 2485256832 |
Fax Number: | 2485291603 |
NPI Enumeration Date: | 05/08/2015 |
NPI Last Update Date: | 05/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM2800X |
License Number: | SA0631371 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Methadone Clinic |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |