Provider Demographics
NPI:1497399745
Name:THERAPY SERVICES OF CLARKSTON
Entity Type:Organization
Organization Name:THERAPY SERVICES OF CLARKSTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:G
Authorized Official - Last Name:SACHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-922-7726
Mailing Address - Street 1:6770 DIXIE HIGHWAY, SUITE 103
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346
Mailing Address - Country:US
Mailing Address - Phone:248-992-7726
Mailing Address - Fax:
Practice Address - Street 1:6770 DIXIE HIGHWAY, SUITE 103
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346
Practice Address - Country:US
Practice Address - Phone:248-992-7726
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)