Healthcare Provider Details

I. General information

NPI: 1013394782
Provider Name (Legal Business Name): LITTS INVESTMENTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 05/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4079 PARK EAST CT SE SUITE C
GRAND RAPIDS MI
49546-8815
US

IV. Provider business mailing address

634 64TH ST
SOUTH HAVEN MI
49090-9379
US

V. Phone/Fax

Practice location:
  • Phone: 269-823-4873
  • Fax:
Mailing address:
  • Phone: 269-823-4873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: AUDREY LITTS
Title or Position: MEMBER
Credential:
Phone: 616-425-2176