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General NPI Number Information
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NPI Number | 1194124842
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Entity Type | Organization
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Legal Business Name | URBAN THERAPEUTIC SERVICES
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 30253 AUSTIN DR
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City | WARREN
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State | MI
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Zip | 48092-1896
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Country | US
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Telephone | 586-770-5566
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Fax |
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Provider Business Mailing Address
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Address Line | 30253 AUSTIN DR
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City | WARREN
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State | MI
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Zip | 48092-1896
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Country | US
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Telephone | 586-770-5566
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JULIAN MICHAEL URBAN
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Credential | COTA/L
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Telephone | 586-770-5566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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