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NPI Code Detail

MEDICARE: ALTUS HOME COUNSELING AND BEHAVIORAL SERVICES LLC

MEDICARE: ALTUS HOME COUNSELING AND BEHAVIORAL SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1477128676
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALTUS HOME COUNSELING AND BEHAVIORAL SERVICES LLC
Provider Business Mailing Address
First Line : 2785 E GRAND BLVD STE 536
Second Line :
City : DETROIT
State : MI
Zip : 48211-2003
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2785 E GRAND BLVD STE 536
Second Line :
City : DETROIT
State : MI
Zip : 48211-2003
Country : US
Telephone Number : 586-359-5269
Fax Number :
Authorized Official
Title or Position : CEO
Name : MS. CHANEL JOHNSON
Credential : LPC
Telephone Number : 586-359-5269
Provider Enumeration Date : 05/21/2021
Last Update Date : 08/31/2023

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Directions to “ALTUS HOME COUNSELING AND BEHAVIORAL SERVICES LLC ” Practice Location

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