Healthcare Provider Details

I. General information

NPI: 1316878788
Provider Name (Legal Business Name): BACK TO YOU CENTRAL PARK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26211 CENTRAL PARK BLVD STE 150
SOUTHFIELD MI
48076-4107
US

IV. Provider business mailing address

1466 LOCHMOOR BLVD
GROSSE POINTE WOODS MI
48236-1761
US

V. Phone/Fax

Practice location:
  • Phone: 248-953-2475
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER AMORI
Title or Position: OWNER
Credential:
Phone: 248-404-8154