Organization
THE THERAPEUTIC LOFT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MASTERMIND I MASTERPEACE LLMSW (THERAPIST)
(231) 445-1173
Entity
Organization
Contact information
Practice address
26677 W 12 MILE RD # 117, SOUTHFIELD, MI 48034-1514
(231) 445-1173
Mailing address
1251 GLYNN CT # C306, DETROIT, MI 48202-1460
(313) 778-0609
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/01/2021
Last updated
04/25/2024
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