Provider Demographics
NPI:1336645092
Name:BEST FRIENDS BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:BEST FRIENDS BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-646-2727
Mailing Address - Street 1:27111 W SIX MILE
Mailing Address - Street 2:CO/ LINDA NOVAK
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:24824-2323
Mailing Address - Country:US
Mailing Address - Phone:734-646-2727
Mailing Address - Fax:
Practice Address - Street 1:950 SEVEN HILLS DR UNIT 122
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4306
Practice Address - Country:US
Practice Address - Phone:734-646-2727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNV20181140282251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health