Provider Demographics
NPI:1942174107
Name:CLEAR STAR WELLNESS AND STAFFING LLC
Entity type:Organization
Organization Name:CLEAR STAR WELLNESS AND STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:EBERECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:AGULANNA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:586-925-6216
Mailing Address - Street 1:38271 MOUND RD STE 300
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-3403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:38271 MOUND RD STE 300
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-3403
Practice Address - Country:US
Practice Address - Phone:586-925-6216
Practice Address - Fax:586-925-6216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)