Provider Demographics
NPI:1316323272
Name:CARE & TRANSFORMATIONAL CENTER
Entity type:Organization
Organization Name:CARE & TRANSFORMATIONAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSBY-LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:LLPC
Authorized Official - Phone:586-983-9280
Mailing Address - Street 1:34514 DEQUINDRE RD
Mailing Address - Street 2:SUITE A1
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-5232
Mailing Address - Country:US
Mailing Address - Phone:586-983-9280
Mailing Address - Fax:586-275-0612
Practice Address - Street 1:34514 DEQUINDRE RD
Practice Address - Street 2:SUITE A1
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-5232
Practice Address - Country:US
Practice Address - Phone:586-983-9280
Practice Address - Fax:586-275-0612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009773251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health