Provider Demographics
NPI:1710613799
Name:JUST TRI RECOVERY
Entity Type:Organization
Organization Name:JUST TRI RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:J
Authorized Official - Last Name:EDWARDS-WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-334-6623
Mailing Address - Street 1:29465 HAZELWOOD ST
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-1541
Mailing Address - Country:US
Mailing Address - Phone:734-334-6623
Mailing Address - Fax:
Practice Address - Street 1:1250 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-1628
Practice Address - Country:US
Practice Address - Phone:734-858-7261
Practice Address - Fax:734-661-6371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty