Healthcare Provider Details

I. General information

NPI: 1124668124
Provider Name (Legal Business Name): BELLE VIE THERAPIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2020
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20816 E 11 MILE RD STE 105
SAINT CLAIR SHORES MI
48081-1578
US

IV. Provider business mailing address

1547 SHORE CLUB DR
SAINT CLAIR SHORES MI
48080-1574
US

V. Phone/Fax

Practice location:
  • Phone: 313-444-3515
  • Fax: 313-556-1373
Mailing address:
  • Phone: 313-444-3515
  • Fax: 313-556-1373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: SARA PRIGORAC
Title or Position: OWNER
Credential: MS, OTRL, CATP
Phone: 810-623-0947