OrganizationActive
Independent Lifestyle Clubhouse LLC
NPI 1235685694 · Adult Mental Health Clinic/Center · Inkster, MI
Provider details
- NPI number
- 1235685694
- Entity type
- Organization
- Primary specialty
- Adult Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Shondra Jackson, Director(313) 622-3287
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(71/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
9 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4427 Inkster Rd
Inkster, MI 48141-3058
Phone: (313) 622-3287
Street-level locationGet directions
Mailing address
29723 Steinhauer St
Inkster, MI 48141-3419
Registry dates
- Enumerated
- 2016-08-26
- Last updated
- 2019-02-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.