=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588979686
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HARMONY TURNING POINT PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2010
-----------------------------------------------------
Last Update Date | 04/24/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20755 GREENFIELD RD SUITE 100
-----------------------------------------------------
City | SOUTHFIELD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48075-5403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-275-3180
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20755 GREENFIELD RD SUITE 100
-----------------------------------------------------
City | SOUTHFIELD
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48075-5403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 248-275-3180
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | JONATHAN AGBEBIYI
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 248-275-3180
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 4301041053
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | 4301041053
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207V00000X
-----------------------------------------------------
Taxonomy Name | Obstetrics & Gynecology Physician
-----------------------------------------------------
License Number | 4301041053
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 207QA0401X
-----------------------------------------------------
Taxonomy Name | Addiction Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number | 4301041053
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------