Provider Demographics
NPI:1104215680
Name:PERCEPTIONS THERAPY L.L.C.
Entity Type:Organization
Organization Name:PERCEPTIONS THERAPY L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMANTHIA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:ZOLNOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MA TLLP
Authorized Official - Phone:586-275-8191
Mailing Address - Street 1:15360 23 MILE RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-1000
Mailing Address - Country:US
Mailing Address - Phone:586-992-6090
Mailing Address - Fax:586-992-6091
Practice Address - Street 1:15360 23 MILE RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-1000
Practice Address - Country:US
Practice Address - Phone:586-992-6090
Practice Address - Fax:586-992-6091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301015090103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty