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General NPI Number Information
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NPI Number | 1376408948
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Entity Type | Organization
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Legal Business Name | PASADENA VILLA MICHIGAN, LLC
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 39500 HIGH POINTE BLVD STE 490
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City | NOVI
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State | MI
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Zip | 48375-5505
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Country | US
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Telephone | 248-826-5876
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Fax |
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Provider Business Mailing Address
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Address Line | 720 COOL SPRINGS BLVD STE 550
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City | FRANKLIN
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State | TN
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Zip | 37067-2645
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | RUSH BRADY
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Credential |
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Telephone | 615-260-2641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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