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General NPI Number Information
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NPI Number | 1063709103
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Entity Type | Organization
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Legal Business Name | NAMASTE FAMILY SERVICES, LLC
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Dates
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Enumeration Date | 07/08/2011
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Last Update Date | 07/08/2011
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Provider Practice Location Address
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Address Line | 114 N MAIN ST SUITE 11
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City | CHELSEA
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State | MI
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Zip | 48118-1539
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Country | US
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Telephone | 734-231-0659
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Fax |
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Provider Business Mailing Address
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Address Line | 114 N MAIN ST STE 11
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City | CHELSEA
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State | MI
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Zip | 48118-1514
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Country | US
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Telephone | 734-231-0659
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. MICHAEL JOHN PATTERSON
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Credential | LMSW
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Telephone | 734-231-0659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 6801065499
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License Number State | MI
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