| Sacred Spaces Of Hope Llc | |
|
2222 W Grand River Ave Ste A Okemos MI 48864-1604 | |
| (810) 624-7892 | |
| Not Available |
| Full Name | Sacred Spaces Of Hope Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2222 W Grand River Ave Ste A, Okemos, Michigan |
| Authorized Official Name and Position | Tayana Holland (OWNER) |
| Authorized Official Contact | 8106247892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sacred Spaces Of Hope Llc 2222 W Grand River Ave Ste A Okemos MI 48864-1604 Ph: () - | Sacred Spaces Of Hope Llc 2222 W Grand River Ave Ste A Okemos MI 48864-1604 Ph: (810) 624-7892 |
| NPI Number | 1326819962 |
|---|---|
| Provider Enumeration Date | 01/11/2024 |
| Last Update Date | 01/11/2024 |
| Certification Date | 01/11/2024 |
| Medicare PECOS PAC ID | 1850736802 |
|---|---|
| Medicare Enrollment ID | O20240229000741 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326819962 | NPI | - | NPPES |
| Provider Name | Tayana La'toya Holland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538779806 PECOS PAC ID: 2769827716 Enrollment ID: I20240329000392 |
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