Healthcare Provider Details

I. General information

NPI: 1275141699
Provider Name (Legal Business Name): ORCHARD LIVING VIEW INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2020
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2532 24 MILE RD
SHELBY TOWNSHIP MI
48316-2762
US

IV. Provider business mailing address

2532 24 MILE RD
SHELBY TOWNSHIP MI
48316-2762
US

V. Phone/Fax

Practice location:
  • Phone: 248-931-6657
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SHELLEY LETZER
Title or Position: OWNER
Credential:
Phone: 248-931-6657