Organization
LIFE RESTORATION COUNSELING & PSYCHOLOGICAL SERVICES
Active
Organization
LIFE RESTORATION COUNSELING & PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY A TAGLIONE (BILLING CEO)
(734) 414-0754
Entity
Organization
Contact information
Practice address
525 E BIG BEAVER RD STE 201, TROY, MI 48083-1363
(248) 709-3897
(248) 828-6364
Mailing address
6489 SHORELINE DR, TROY, MI 48085-1048
(248) 709-3897
(248) 828-6364
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6301009751
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103T00000X
TAXONOMY
—
01
—
1992124390
NPI
MI
Enumeration date
01/16/2018
Last updated
01/16/2018
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