Provider Demographics
NPI:1659653780
Name:TRAINING AND TREATMENT INNOVATIONS INC
Entity Type:Organization
Organization Name:TRAINING AND TREATMENT INNOVATIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KISS WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-969-9932
Mailing Address - Street 1:1450 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-6108
Mailing Address - Country:US
Mailing Address - Phone:248-969-9932
Mailing Address - Fax:248-969-3006
Practice Address - Street 1:929 STEVENS ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-1620
Practice Address - Country:US
Practice Address - Phone:810-232-6081
Practice Address - Fax:810-232-6510
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRAINING AND TREATMENT INNOVATIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-14
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P02590Medicare PIN