Provider Demographics
| NPI: | 1760926679 |
|---|---|
| Name: | OAKLAND THERAPY LLC |
| Entity type: | Organization |
| Organization Name: | OAKLAND THERAPY LLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DIRECTOR |
| Authorized Official - Prefix: | MS |
| Authorized Official - First Name: | PULVINDER |
| Authorized Official - Middle Name: | K |
| Authorized Official - Last Name: | GREWAL |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 248-865-9418 |
| Mailing Address - Street 1: | 7125 ORCHARD LAKE RD STE 222 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WEST BLOOMFIELD |
| Mailing Address - State: | MI |
| Mailing Address - Zip Code: | 48322-3616 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 248-865-9418 |
| Mailing Address - Fax: | 248-865-9420 |
| Practice Address - Street 1: | 7125 ORCHARD LAKE RD STE 222 |
| Practice Address - Street 2: | |
| Practice Address - City: | WEST BLOOMFIELD |
| Practice Address - State: | MI |
| Practice Address - Zip Code: | 48322-3616 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 248-865-9418 |
| Practice Address - Fax: | 248-865-9420 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2016-12-12 |
| Last Update Date: | 2022-05-23 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
| No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | Group - Multi-Specialty |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
| No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty |
