| Life 180 Group | |
|
26632 Potomac Ct Center Line MI 48015-1626 | |
| (313) 878-2732 | |
| Not Available |
| Full Name | Life 180 Group |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 26632 Potomac Ct, Center Line, Michigan |
| Authorized Official Name and Position | Marqueisha A Brown (CEO) |
| Authorized Official Contact | 3138782732 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life 180 Group 26632 Potomac Ct Center Line MI 48015-1626 Ph: (313) 878-2732 | Life 180 Group 26632 Potomac Ct Center Line MI 48015-1626 Ph: (313) 878-2732 |
| NPI Number | 1932784121 |
|---|---|
| Provider Enumeration Date | 03/10/2021 |
| Last Update Date | 04/03/2024 |
| Certification Date | 04/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932784121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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