Provider Demographics
NPI:1194124842
Name:URBAN THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:URBAN THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:URBAN
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:586-770-5566
Mailing Address - Street 1:30253 AUSTIN DR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-1896
Mailing Address - Country:US
Mailing Address - Phone:586-770-5566
Mailing Address - Fax:
Practice Address - Street 1:30253 AUSTIN DR
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48092-1896
Practice Address - Country:US
Practice Address - Phone:586-770-5566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility