MEDICARE: INDIVIDUALIZED QUALITY THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XH1200X	Hand Occupational Therapist

General Provider Information

NPI Number	:	1235085051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDIVIDUALIZED QUALITY THERAPY LLC

Provider Business Mailing Address
First Line	:	836 CENTENNIAL WAY STE 160
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-8238
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1568 LAKE LANSING RD
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48912-3707
Country	:	US
Telephone Number	:	517-798-3677
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS OWNER
Name	:	SYDNEY SABAN
Credential	:
Telephone Number	:	517-798-3677

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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