Provider Demographics
NPI:1366899205
Name:NEXT LEVEL HOME THERAPY SERVICES
Entity type:Organization
Organization Name:NEXT LEVEL HOME THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HEILMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-388-1362
Mailing Address - Street 1:9760 MANDON RD
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-2949
Mailing Address - Country:US
Mailing Address - Phone:248-388-1362
Mailing Address - Fax:810-720-6389
Practice Address - Street 1:9760 MANDON RD
Practice Address - Street 2:
Practice Address - City:WHITE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48386-2949
Practice Address - Country:US
Practice Address - Phone:248-388-1362
Practice Address - Fax:810-720-6389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501016732225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty