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General NPI Number Information
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NPI Number | 1861882821
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Entity Type | Organization
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Legal Business Name | INCLUSIVE SOLUTIONS LLC
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 4535 CHRYSLER DR
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City | DETROIT
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State | MI
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Zip | 48201-1954
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Country | US
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Telephone | 313-833-7593
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Fax |
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Provider Business Mailing Address
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Address Line | 26721 ANN ARBOR TRL
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-1001
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Country | US
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Telephone | 313-676-0013
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DAVID DELL ELLIS
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Credential |
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Telephone | 313-676-0013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | AS820360989
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License Number State | MI
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