Healthcare Provider Details

I. General information

NPI: 1497399745
Provider Name (Legal Business Name): THERAPY SERVICES OF CLARKSTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2019
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6770 DIXIE HIGHWAY, SUITE 103
CLARKSTON MI
48346
US

IV. Provider business mailing address

6770 DIXIE HIGHWAY, SUITE 103
CLARKSTON MI
48346
US

V. Phone/Fax

Practice location:
  • Phone: 248-992-7726
  • Fax:
Mailing address:
  • Phone: 248-992-7726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. DIANNE G SACHE
Title or Position: OFFICE MANAGER/AUTHORIZED OFFICIAL
Credential:
Phone: 248-922-7726