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NPI Code Detail

MEDICARE: VARIETY FAR CONSERVATORY

MEDICARE: VARIETY FAR CONSERVATORY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency

General Provider Information

NPI Number : 1053566398
Entity Type Code : Organization
Provider Name (Legal Business Name) : VARIETY FAR CONSERVATORY
Provider Business Mailing Address
First Line : 1669 W MAPLE RD
Second Line :
City : BIRMINGHAM
State : MI
Zip : 48009-1230
Country : US
Telephone Number : 248-646-3347
Fax Number : 480-247-5901
Provider Business Practice Location Address
First Line : 1669 W MAPLE RD
Second Line :
City : BIRMINGHAM
State : MI
Zip : 48009-1230
Country : US
Telephone Number : 248-646-3347
Fax Number : 480-247-5901
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. ARLENE KASS
Credential :
Telephone Number : 248-646-3347
Provider Enumeration Date : 12/01/2008
Last Update Date : 12/01/2008

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Directions to “VARIETY FAR CONSERVATORY ” Practice Location

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