Provider Demographics
NPI:1740991769
Name:NURTURING SELVES
Entity type:Organization
Organization Name:NURTURING SELVES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CHILD AND FAMILY THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARCHAMBAULT SELVES
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, RPT-S
Authorized Official - Phone:810-964-9242
Mailing Address - Street 1:6531 N SEYMOUR RD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-1007
Mailing Address - Country:US
Mailing Address - Phone:810-964-9242
Mailing Address - Fax:
Practice Address - Street 1:1507 E PIERSON RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-1816
Practice Address - Country:US
Practice Address - Phone:810-964-9242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health