OrganizationActive
Blue Light Inc.
NPI 1497168215 · Developmental Disabilities Clinic/Center · Wayne, MI
Provider details
- NPI number
- 1497168215
- Entity type
- Organization
- Primary specialty
- Developmental Disabilities Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Phyllis Clark, Executive Director(313) 999-4890
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
26105 Orchard Lake Rd Suite #208 Farmington Hills Mi 48
35115 E Michigan Ave
Wayne, MI 48184
Phone: (248) 615-3042
Fax: (248) 615-3047
Approximate (ZIP-level) locationGet directions
Mailing address
26105 Orchard Lake Rd
Farmington Hills, MI 48334-4576
Registry dates
- Enumerated
- 2014-06-09
- Last updated
- 2024-11-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.