Healthcare Provider Details

I. General information

NPI: 1356751150
Provider Name (Legal Business Name): LKS SOLUTIONS FOCUSED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2014
Last Update Date: 05/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3631 REEVES DR
MELVINDALE MI
48122-2018
US

IV. Provider business mailing address

3631 REEVES DR
MELVINDALE MI
48122-2018
US

V. Phone/Fax

Practice location:
  • Phone: 313-899-0920
  • Fax:
Mailing address:
  • Phone: 313-899-0920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number6801093283
License Number StateMI

VIII. Authorized Official

Name: LASHONDA SMITH
Title or Position: LLMSW
Credential:
Phone: 313-899-0920