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General NPI Number Information
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NPI Number | 1962194845
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Entity Type | Organization
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Legal Business Name | HAUS OF HEALTHY LIVING, LLC
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Dates
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Enumeration Date | 05/22/2023
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 22000 GRAND RIVER AVE # 300
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City | DETROIT
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State | MI
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Zip | 48219-3262
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Country | US
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Telephone | 313-946-9644
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Fax |
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Provider Business Mailing Address
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Address Line | 22000 GRAND RIVER AVE # 300
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City | DETROIT
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State | MI
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Zip | 48219-3262
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Country | US
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Telephone | 313-946-9644
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. KARLA K MITCHELL
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Credential | ND
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Telephone | 313-946-9644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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