Organization
BLUE LYTE INC.
Active
Other names
Blue Lyte Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS CLARK (EXECUTIVE DIRECTOR)
(248) 615-3042
Entity
Organization
Contact information
Practice address
35115 E MICHIGAN AVE, WAYNE, MI 48184-1660
(248) 615-3042
(248) 615-3047
Mailing address
35115 E MICHIGAN AVE, WAYNE, MI 48184-1660
(248) 615-3042
(248) 615-3047
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
Other
Enumeration date
01/23/2018
Last updated
01/19/2023
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