Provider Demographics
NPI:1477190155
Name:JR BRILL INC
Entity Type:Organization
Organization Name:JR BRILL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JULIAN
Authorized Official - Last Name:BRILL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-431-1047
Mailing Address - Street 1:8125 PEPPER RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-8657
Mailing Address - Country:US
Mailing Address - Phone:248-431-1047
Mailing Address - Fax:
Practice Address - Street 1:4345 MEIGS AVE
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48329-1877
Practice Address - Country:US
Practice Address - Phone:248-431-1047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health