Provider Demographics
NPI:1043764301
Name:UNIQUE PRISON CONSULTANTS & COACHING, LLC
Entity Type:Organization
Organization Name:UNIQUE PRISON CONSULTANTS & COACHING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:METECIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-433-3621
Mailing Address - Street 1:11138 FINDLAY ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48205-4714
Mailing Address - Country:US
Mailing Address - Phone:313-433-3621
Mailing Address - Fax:313-922-4689
Practice Address - Street 1:11138 FINDLAY ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48205-4714
Practice Address - Country:US
Practice Address - Phone:313-433-3621
Practice Address - Fax:313-922-4689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty