Healthcare Provider Details

I. General information

NPI: 1649134271
Provider Name (Legal Business Name): EMERGING MINDS CHILDREN'S CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22371 W VILLAGE DR
DEARBORN MI
48124-2236
US

IV. Provider business mailing address

22371 W VILLAGE DR
DEARBORN MI
48124-2236
US

V. Phone/Fax

Practice location:
  • Phone: 313-800-2121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: AMANDA KAROUT
Title or Position: ORGANIZER
Credential: BCBA
Phone: 313-800-2121