FAITH AND RADICAL SELF-LOVE LLC NPI 1205441722

NPI Information

NPI: 1205441722
Provider Name: FAITH AND RADICAL SELF-LOVE, LLC

Doing Business As: LENORAS LIGHT

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
22804 SHARROW AVE
WARREN, MI
ZIP 48089
Phone: (313) 854-5102
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FAITH AND RADICAL SELF-LOVE, LLC is a mental health (including community mental health center) clinic center in Warren, MI. FAITH AND RADICAL SELF-LOVE, LLC NPI is 1205441722. The provider is registered as an organization entity type.
The provider Is Doing Business As Lenoras Light.

The provider's business location address is:

22804 SHARROW AVE
WARREN, MI
ZIP 48089-882
Phone: (313) 854-5102
Fax: (313) 251-7344

The provider's authorized official is Zenobia Kindle-davis .
The authorized official title is Therapist/owner and has the following contact phone number (313) 854-5102.

The enumeration date for this NPI number is 9/11/2020 and was last updated on 2/4/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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