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General NPI Number Information
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NPI Number | 1174998801
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Entity Type | Organization
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Legal Business Name | LEVEL ELEVEN HOWELL
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Dates
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Enumeration Date | 12/07/2015
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Last Update Date | 09/26/2023
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Provider Practice Location Address
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Address Line | 1030 W. HIGHLAND RD
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City | HOWELL
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State | MI
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Zip | 48843
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Country | US
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Telephone | 810-771-7686
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Fax |
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Provider Business Mailing Address
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Address Line | 10483 DIXIE HWY
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City | HOLLY
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State | MI
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Zip | 48442-9311
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Country | US
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Telephone | 810-771-7686
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Fax | 810-771-7685
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | HEATHER WILSON
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Credential |
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Telephone | 502-272-3463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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