Provider Demographics
NPI:1255175360
Name:MAKE YOUR TURN LLC
Entity type:Organization
Organization Name:MAKE YOUR TURN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNELL
Authorized Official - Middle Name:
Authorized Official - Last Name:GEMUS
Authorized Official - Suffix:JR
Authorized Official - Credentials:PA-C
Authorized Official - Phone:734-265-0120
Mailing Address - Street 1:1645 N DIXIE HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-5231
Mailing Address - Country:US
Mailing Address - Phone:734-344-7432
Mailing Address - Fax:734-344-7431
Practice Address - Street 1:1645 N DIXIE HWY STE 2
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-5231
Practice Address - Country:US
Practice Address - Phone:734-344-7432
Practice Address - Fax:734-344-7431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1609381755Medicaid
MI1801233614Medicaid
MI1255175360Medicaid
MI1265805766Medicaid
OH0053314Medicaid
MI1699301374Medicaid
MI1851909923Medicaid