Provider Demographics
NPI:1164382073
Name:SPIRITUALLY FIT LLC
Entity type:Organization
Organization Name:SPIRITUALLY FIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:LAVONNE
Authorized Official - Last Name:TRAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-362-1472
Mailing Address - Street 1:11807 DUCHESS ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-1593
Mailing Address - Country:US
Mailing Address - Phone:313-312-4316
Mailing Address - Fax:
Practice Address - Street 1:43443 MEADOWLARK CIR
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-3351
Practice Address - Country:US
Practice Address - Phone:586-362-1472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-13
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care