Provider Demographics
NPI:1063193233
Name:DOWNTOWN WELLNESS PLLC
Entity type:Organization
Organization Name:DOWNTOWN WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:248-894-0824
Mailing Address - Street 1:412 S BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-1626
Mailing Address - Country:US
Mailing Address - Phone:248-894-0824
Mailing Address - Fax:
Practice Address - Street 1:104 E MAPLE ST
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-2101
Practice Address - Country:US
Practice Address - Phone:810-373-9062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)