Healthcare Provider Details

I. General information

NPI: 1235560764
Provider Name (Legal Business Name): BETTER LIFE LEARNING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2013
Last Update Date: 05/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33717 WOODWARD AVE #253
BIRMINGHAM MI
48009
US

IV. Provider business mailing address

33717 WOODWARD AVE #253
BIRMINGHAM MI
48009
US

V. Phone/Fax

Practice location:
  • Phone: 248-850-5293
  • Fax:
Mailing address:
  • Phone: 248-850-5293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH LENORA MILTON
Title or Position: ASTHMA PROGRAM MANAGER
Credential: RN, AE-C
Phone: 248-850-5293