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General NPI Number Information
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NPI Number | 1730067455
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Entity Type | Organization
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Legal Business Name | JOSHUA OF JORDAN INDUSTRY OF CONSULTATION AND INVESTMENT
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 17515 W 9 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4403
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Country | US
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Telephone | 313-600-2904
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Fax |
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Provider Business Mailing Address
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Address Line | 17515 W 9 MILE RD STE 935
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4406
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Country | US
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Telephone | 313-600-2904
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MR. DENVER LEE
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Credential |
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Telephone | 313-600-2904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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