Mi Quiet Oasis Therapy Llc. | |
2838 S 56th Ave Shelby MI 49455-9761 | |
(231) 742-1208 | |
Not Available |
Full Name | Mi Quiet Oasis Therapy Llc. |
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Speciality | Clinic/Center |
Location | 2838 S 56th Ave, Shelby, Michigan |
Authorized Official Name and Position | Jennifer Leigh James-witteveen (OWNER/PROVIDER) |
Authorized Official Contact | 2317421208 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mi Quiet Oasis Therapy Llc. 2838 S 56th Ave Shelby MI 49455-9761 Ph: (231) 742-1208 | Mi Quiet Oasis Therapy Llc. 2838 S 56th Ave Shelby MI 49455-9761 Ph: (231) 742-1208 |
NPI Number | 1023851110 |
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Provider Enumeration Date | 06/17/2024 |
Last Update Date | 06/17/2024 |
Certification Date | 06/17/2024 |
Medicare PECOS PAC ID | 5799211298 |
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Medicare Enrollment ID | O20241206003027 |
Identifier | Type | State | Issuer |
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1023851110 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | Jennifer Leigh James-witteveen |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1902173784 PECOS PAC ID: 0042681736 Enrollment ID: I20241206003084 |
Three Cs Professional Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 E 6th St, Shelby, MI 49455 Phone: 616-450-2284 |