Provider Demographics
NPI:1689471476
Name:POBODY IS NERFECT
Entity type:Organization
Organization Name:POBODY IS NERFECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:TESTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-890-6671
Mailing Address - Street 1:28470 SHADYLANE DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-2155
Mailing Address - Country:US
Mailing Address - Phone:248-219-5341
Mailing Address - Fax:
Practice Address - Street 1:28470 SHADYLANE DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-2155
Practice Address - Country:US
Practice Address - Phone:248-219-5341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health