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General NPI Number Information
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NPI Number | 1598746489
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Entity Type | Organization
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Legal Business Name | CENTRAL THERAPEUTIC SERVICES INC
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17600 W 8 MILE RD SUITE #7
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4305
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Country | US
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Telephone | 248-559-4340
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Fax | 248-559-1451
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Provider Business Mailing Address
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Address Line | 17600 W 8 MILE RD SUITE #7
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4305
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Country | US
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Telephone | 248-559-4340
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Fax | 248-559-1451
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST/PRESIDENT/CEO
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Name | DR. K G THIMOTHEOSE
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Credential | PHD
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Telephone | 248-559-4340
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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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