=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740391481
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ULTIMATE SOLUTIONS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 29240 BUCKINGHAM ST SUITE #11
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48154-4575
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-513-2800
-----------------------------------------------------
Fax | 734-513-3606
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 29240 BUCKINGHAM ST SUITE #11
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48154-4575
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-513-2800
-----------------------------------------------------
Fax | 734-513-3606
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROJECT DIRECTOR
-----------------------------------------------------
Name | DR. VERONA MORTON
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 734-513-2800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 324500000X
-----------------------------------------------------
Taxonomy Name | Substance Abuse Rehabilitation Facility
-----------------------------------------------------
License Number | RU0335756
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------