Healthcare Provider Details

I. General information

NPI: 1972930477
Provider Name (Legal Business Name): TRAINING & TREATMENT INNOVATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 E BIG BEAVER RD
TROY MI
48083-1905
US

IV. Provider business mailing address

1225 E BIG BEAVER RD
TROY MI
48083-1905
US

V. Phone/Fax

Practice location:
  • Phone: 248-524-8801
  • Fax: 248-524-8850
Mailing address:
  • Phone: 248-524-8801
  • Fax: 248-524-8850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LATONIA TAYLOR
Title or Position: SUPPORTS COORDINATOR
Credential:
Phone: 248-524-8801