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General NPI Number Information
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NPI Number | 1528517588
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Entity Type | Organization
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Legal Business Name | UNIQUE PRISON CONSULTANTS & COACHING, LLC
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Dates
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Enumeration Date | 09/30/2016
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Last Update Date | 09/30/2016
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Provider Practice Location Address
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Address Line | 11138 FINDLAY ST
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City | DETROIT
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State | MI
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Zip | 48205-4714
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Country | US
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Telephone | 313-433-3621
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Fax | 313-922-4689
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Provider Business Mailing Address
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Address Line | 11138 FINDLAY STREET
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City | DETROIT
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State | MI
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Zip | 48205
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Country | US
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Telephone | 313-433-3621
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Fax | 313-922-4689
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Authorized Official
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Title or Position | CEO
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Name | METECIA SMITH
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Credential |
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Telephone | 313-433-3621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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