1720413057 NPI number — STABLE TODAY INSPIRATIONAL COUNSELING AND LITERATURE AGENCY S

Table of content: ASMIRIA FRANCO SULBARAN M.D. (NPI 1720433493)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720413057 NPI number — STABLE TODAY INSPIRATIONAL COUNSELING AND LITERATURE AGENCY S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STABLE TODAY INSPIRATIONAL COUNSELING AND LITERATURE AGENCY S
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720413057
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15542 PEBBLEBROOK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLEVILLE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48111-5188
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-904-8848
Provider Business Mailing Address Fax Number:
734-414-0769

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15542 PEBBLEBROOK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVILLE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48111-5188
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-904-8848
Provider Business Practice Location Address Fax Number:
734-414-0769
Provider Enumeration Date:
09/05/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CURRY
Authorized Official First Name:
DELORIS
Authorized Official Middle Name:
Authorized Official Title or Position:
LMSW
Authorized Official Telephone Number:
734-904-8848

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  6801063304 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1114212339 . This is a "IND NPI #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6801063304 . This is a "LICENSE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".