Healthcare Provider Details

I. General information

NPI: 1871457655
Provider Name (Legal Business Name): 2 AS 1 FOREVER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 WILLIAMSON CIR
PONTIAC MI
48340-3314
US

IV. Provider business mailing address

1080 WILLIAMSON CIR
PONTIAC MI
48340-3314
US

V. Phone/Fax

Practice location:
  • Phone: 947-999-6949
  • Fax:
Mailing address:
  • Phone: 947-999-6949
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: BEVERLY V THOMAS
Title or Position: OWNER
Credential:
Phone: 947-999-6949