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General NPI Number Information
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NPI Number | 1205588829
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Entity Type | Organization
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Legal Business Name | CENTER FOR RESILIENCE EMPOWERMENT AND WELLNESS PC
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Dates
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Enumeration Date | 01/25/2022
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 705 BARCLAY CIR
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-5806
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Country | US
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Telephone | 855-763-2739
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Fax | 248-601-5111
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Provider Business Mailing Address
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Address Line | 1318 E HORSESHOE BEND DR
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City | ROCHESTER HILLS
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State | MI
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Zip | 48306-4140
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Country | US
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Telephone | 248-212-7667
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Fax | 248-601-5111
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JOELLE KEKHOUA
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Credential | LPC
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Telephone | 248-212-7667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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