Provider Demographics
NPI:1063971430
Name:THE HIGH VIBRATION STATION, PLLC
Entity type:Organization
Organization Name:THE HIGH VIBRATION STATION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:CASTILE
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CAADC, RYT
Authorized Official - Phone:810-328-3461
Mailing Address - Street 1:1807 ANITA AVE
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1439
Mailing Address - Country:US
Mailing Address - Phone:810-328-3461
Mailing Address - Fax:810-746-0114
Practice Address - Street 1:22930 E 9 MILE RD STE B
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1985
Practice Address - Country:US
Practice Address - Phone:810-328-3461
Practice Address - Fax:810-746-0114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-15
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization