Organization
ENVISION WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALTHEA D SMITH MENTAL HEALTH COUNSE (THERAPIST)
(248) 990-6384
Entity
Organization
Contact information
Practice address
26677 W 12 MILE RD STE 136, SOUTHFIELD, MI 48034-1514
(248) 990-6384
Mailing address
26677 W 12 MILE RD STE 136, SOUTHFIELD, MI 48034-1514
(248) 990-6384
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/11/2018
Last updated
06/16/2018
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