| Dream Professional Services, Llc | |
|
5640 W Maple Rd Suite 310 West Bloomfield MI 48322-3716 | |
| (248) 932-0290 | |
| (248) 932-0358 |
| Full Name | Dream Professional Services, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5640 W Maple Rd, West Bloomfield, Michigan |
| Authorized Official Name and Position | Kathleen Michelle Fouche Brazzle (PRESIDENT) |
| Authorized Official Contact | 2489320290 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dream Professional Services, Llc 5640 W Maple Rd Suite 310 West Bloomfield MI 48322-3716 Ph: (248) 932-0290 | Dream Professional Services, Llc 5640 W Maple Rd Suite 310 West Bloomfield MI 48322-3716 Ph: (248) 932-0290 |
| NPI Number | 1417251943 |
|---|---|
| Provider Enumeration Date | 12/23/2010 |
| Last Update Date | 12/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417251943 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 4301052026 (Michigan) | Primary |
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