Provider Demographics
NPI:1063874311
Name:PERSONAL BEST T & C
Entity type:Organization
Organization Name:PERSONAL BEST T & C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:ARTINA
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-953-5916
Mailing Address - Street 1:17800 WOODWARD AVE
Mailing Address - Street 2:SUITE LL1
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48203-2297
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17800 WOODWARD AVE
Practice Address - Street 2:SUITE LL1
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48203-2297
Practice Address - Country:US
Practice Address - Phone:313-649-5854
Practice Address - Fax:313-733-4137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-25
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Single Specialty