Provider Demographics
NPI:1578302956
Name:HUMANISTIC POTENTIAL CENTER INC
Entity type:Organization
Organization Name:HUMANISTIC POTENTIAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER / AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEYAERT
Authorized Official - Suffix:
Authorized Official - Credentials:MA LLP
Authorized Official - Phone:734-968-9050
Mailing Address - Street 1:1469 OAK ST
Mailing Address - Street 2:
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192-5525
Mailing Address - Country:US
Mailing Address - Phone:734-968-9050
Mailing Address - Fax:
Practice Address - Street 1:1469 OAK ST
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-5525
Practice Address - Country:US
Practice Address - Phone:734-968-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty