Provider Demographics
NPI: | 1760926679 |
---|---|
Name: | OAKLAND THERAPY LLC |
Entity Type: | Organization |
Organization Name: | OAKLAND THERAPY LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | PULVINDER |
Authorized Official - Middle Name: | K |
Authorized Official - Last Name: | GREWAL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 248-865-9418 |
Mailing Address - Street 1: | 7125 ORCHARD LAKE RD STE 222 |
Mailing Address - Street 2: | |
Mailing Address - City: | WEST BLOOMFIELD |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48322-3616 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 248-865-9418 |
Mailing Address - Fax: | 248-865-9420 |
Practice Address - Street 1: | 7125 ORCHARD LAKE RD STE 222 |
Practice Address - Street 2: | |
Practice Address - City: | WEST BLOOMFIELD |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48322-3616 |
Practice Address - Country: | US |
Practice Address - Phone: | 248-865-9418 |
Practice Address - Fax: | 248-865-9420 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-12-12 |
Last Update Date: | 2022-05-23 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |