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General NPI Number Information
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NPI Number | 1154914059
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Entity Type | Organization
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Legal Business Name | EAGER MINDS MONTESSORI LLC
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Dates
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Enumeration Date | 02/11/2021
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Last Update Date | 02/12/2021
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Provider Practice Location Address
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Address Line | 2100 BLOOMFIELD WOODS CT # 48323
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48323-1913
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Country | US
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Telephone | 248-703-7940
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 BLOOMFIELD WOODS CT # 48323
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48323-1913
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Country | US
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Telephone | 248-703-7940
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JAYEETA CHAMPATI
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Credential |
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Telephone | 248-703-7940
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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 |
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License Number State |
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