OrganizationActive
Healing Haven Ancillary Services, LLC
NPI 1063101384 · Pediatric Occupational Therapist · Madison Hts, MI
Provider details
- NPI number
- 1063101384
- Entity type
- Organization
- Primary specialty
- Pediatric Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Jamie Mcgillivary, Ceo(248) 965-3916
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Speech-Language Pathologist235Z00000X
Speech, Language and Hearing Service Providers
Practice location
30821 Barrington St
Madison Hts, MI 48071-1871
Phone: (248) 965-3916
Approximate (ZIP-level) locationGet directions
Mailing address
30821 Barrington St
Madison Hts, MI 48071-1871
Registry dates
- Enumerated
- 2023-05-03
- Last updated
- 2025-01-30
- Certified
- 2025-01-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.