Healthcare Provider Details

I. General information

NPI: 1104761568
Provider Name (Legal Business Name): J 2 K CONSULTING FIRM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 E 14 MILE RD
BIRMINGHAM MI
48009-2093
US

IV. Provider business mailing address

703 E 14 MILE RD
BIRMINGHAM MI
48009-2093
US

V. Phone/Fax

Practice location:
  • Phone: 248-763-6690
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: VENUS KELSO
Title or Position: INDEPENDENT SUPPORTS COORDINATOR
Credential:
Phone: 248-763-6690