Healthcare Provider Details
I. General information
NPI: 1386991354
Provider Name (Legal Business Name): PRESCRIBED THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/09/2012
Last Update Date: 03/17/2023
Certification Date: 03/17/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2820 W MAPLE RD STE 201A
TROY MI
48084-7064
US
IV. Provider business mailing address
PO BOX 1465
TROY MI
48099-1465
US
V. Phone/Fax
- Phone: 248-324-4663
- Fax: 248-324-4664
- Phone: 248-324-4663
- Fax: 248-324-4664
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
F
LOBO
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 248-324-4663