Provider Demographics
NPI:1871544577
Name:MAX WELL THERAPY L.L.C.
Entity type:Organization
Organization Name:MAX WELL THERAPY L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILLAYNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:810-230-9750
Mailing Address - Street 1:1289 S LINDEN RD STE A
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3499
Mailing Address - Country:US
Mailing Address - Phone:810-230-9750
Mailing Address - Fax:810-230-8799
Practice Address - Street 1:1289 S LINDEN RD STE A
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3499
Practice Address - Country:US
Practice Address - Phone:810-230-9750
Practice Address - Fax:810-230-8799
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAX WELL THERAPY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B511320OtherBCBS GROUP #
MI0B50886OtherBCBS OT
0B50901OtherBCBS SP
MI1008285OtherMCLAREN HEALTH ADVANTAGE
MI7368023OtherAETNA
MI383335OtherPPOM
MI105378600OtherUS DEPT OF LABOR
MI4383090Medicaid
MI1008285OtherMCLAREN HEALTH ADVANTAGE