Organization Active NPI

Jupiter Wellness Co LLC

  • Health Service Clinic/Center
  • Detroit, MI
National Provider Identifier
1659235224
Registry record updated Dec 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
JUPITER WELLNESS CO LLC
Practice address
18218 James Couzens Fwy
Detroit, MI 48235-2501
Phone
(313) 699-5301
NPI assigned
Dec 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mallary Jackson, LMTNPI 1851253702
Title
LMT
Phone
(313) 699-5301

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

18218 James Couzens Fwy
Detroit, MI 48235-2501

Mailing address

41470 E Archwood Dr Apt 134
Van Buren Township, MI 48111-4525
Phone (313) 699-5301

National Provider Directory

National Provider Directory

Locations

18218 James Couzens Fwy
Detroit, MI 48235
Phone (313) 699-5301

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1765238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765238400000",
    "number": "1659235224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41470 E ARCHWOOD DR APT 134",
            "city": "VAN BUREN TOWNSHIP",
            "state": "MI",
            "postal_code": "481114525",
            "telephone_number": "313-699-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18218 JAMES COUZENS FWY",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352501",
            "telephone_number": "313-699-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUPITER WELLNESS CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-09",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MALLARY",
        "authorized_official_title_or_position": "LMT",
        "authorized_official_telephone_number": "313-699-5301",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.