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General NPI Number Information
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NPI Number | 1245112267
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Entity Type | Organization
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Legal Business Name | LUNEXA HEALTH LLC
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 24681 NORTHWESTERN HWY STE 4011
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2305
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Country | US
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Telephone | 313-217-1367
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Fax |
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Provider Business Mailing Address
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Address Line | 24681 NORTHWESTERN HWY STE 4011
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City | SOUTHFIELD
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State | MI
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Zip | 48075-2305
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Country | US
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Telephone | 313-217-1367
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Fax | 313-217-1367
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. CHANELLE KAJY
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Credential |
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Telephone | 800-283-0622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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