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NPI Code Detail

MEDICARE: THE CHILDREN'S CENTER OF WAYNE CO., INC.

MEDICARE: THE CHILDREN'S CENTER OF WAYNE CO., INC.
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
1251B00000XCase Management Agency
2253J00000XFoster Care Agency
3252Y00000XEarly Intervention Provider Agency
4251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1653610OTHERMICONSUMERLINK
2000100OTHERMICARELINK
3118605OTHERMIVALUE OPTIONS
41528145844OTHERMIBCN
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6750910564OTHERMIBCBS

General Provider Information

NPI Number : 1528145844
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CHILDREN'S CENTER OF WAYNE CO., INC.
Provider Business Mailing Address
First Line : 79 W ALEXANDRINE ST
Second Line :
City : DETROIT
State : MI
Zip : 48201-2015
Country : US
Telephone Number : 313-831-5535
Fax Number : 313-447-2623
Provider Business Practice Location Address
First Line : 79 W ALEXANDRINE ST
Second Line :
City : DETROIT
State : MI
Zip : 48201-2015
Country : US
Telephone Number : 313-831-5535
Fax Number : 313-447-2623
Authorized Official
Title or Position : DIRECTOR - RCM & CLIENT RELATIONS
Name : TIFFANY LEID
Credential :
Telephone Number : 313-262-0951
Provider Enumeration Date : 11/01/2006
Last Update Date : 05/23/2022

Similar Medicare Providers

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Practice Location Address:
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1215578745 — JASMINE WAYNE
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1689533655 — MICHAEL DAVID ADAMS LLMSW
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1659395044 — DR. CECILIA JAVIER ASTORGA-SWITZER M.D.
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1447351549 — MRS. MURIEL RUTH COLASINSKI LLPC
Practice Location Address:
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Practice Fax:
1730234410 — MS. SUSAN ELLEN BINDER-DEMOTT MA, LLP
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Directions to “THE CHILDREN'S CENTER OF WAYNE CO., INC. ” Practice Location

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