| Provision Company, Llc | |
|
2222 W Grand River Ave Ste 2 Okemos MI 48864-1604 | |
| (734) 992-7868 | |
| Not Available |
| Full Name | Provision Company, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2222 W Grand River Ave Ste 2, Okemos, Michigan |
| Authorized Official Name and Position | Patrice Barden (OWNER) |
| Authorized Official Contact | 7349927868 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provision Company, Llc Po Box 74153 Romulus MI 48174-0153 Ph: (734) 992-7868 | Provision Company, Llc 2222 W Grand River Ave Ste 2 Okemos MI 48864-1604 Ph: (734) 992-7868 |
| NPI Number | 1497440531 |
|---|---|
| Provider Enumeration Date | 04/05/2023 |
| Last Update Date | 04/05/2023 |
| Certification Date | 04/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497440531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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