Provider Demographics
NPI:1972019917
Name:ARUKAH WELLNESS JOURNEY LLC
Entity Type:Organization
Organization Name:ARUKAH WELLNESS JOURNEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JATERA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MAING
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:734-386-0560
Mailing Address - Street 1:2385 S HURON PKWY STE 2N
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-5127
Mailing Address - Country:US
Mailing Address - Phone:734-386-0560
Mailing Address - Fax:734-882-2861
Practice Address - Street 1:2385 S HURON PKWY STE 2N
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-5127
Practice Address - Country:US
Practice Address - Phone:734-386-0560
Practice Address - Fax:734-882-2861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-27
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010935251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty