Healthcare Provider Details

I. General information

NPI: 1154114023
Provider Name (Legal Business Name): UNITY MIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4310 LOIS ST
DEARBORN MI
48126-4026
US

IV. Provider business mailing address

4310 LOIS ST
DEARBORN MI
48126-4026
US

V. Phone/Fax

Practice location:
  • Phone: 313-558-1747
  • Fax:
Mailing address:
  • Phone: 313-558-1747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ISMAIL ALKAHALI
Title or Position: OWNER
Credential:
Phone: 313-558-1747