| The Therapeutic Loft Llc | |
|
26677 W 12 Mile Rd # 117 Southfield MI 48034-1514 | |
| (231) 445-1173 | |
| Not Available |
| Full Name | The Therapeutic Loft Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 26677 W 12 Mile Rd # 117, Southfield, Michigan |
| Authorized Official Name and Position | Mastermind I Masterpeace (THERAPIST) |
| Authorized Official Contact | 2314451173 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Therapeutic Loft Llc 1251 Glynn Ct # C306 Detroit MI 48202-1460 Ph: (313) 778-0609 | The Therapeutic Loft Llc 26677 W 12 Mile Rd # 117 Southfield MI 48034-1514 Ph: (231) 445-1173 |
| NPI Number | 1457942583 |
|---|---|
| Provider Enumeration Date | 02/01/2021 |
| Last Update Date | 04/25/2024 |
| Certification Date | 04/25/2024 |
| Medicare PECOS PAC ID | 7911305529 |
|---|---|
| Medicare Enrollment ID | O20211013000400 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457942583 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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