Healthcare Provider Details
I. General information
NPI: 1235403338
Provider Name (Legal Business Name): FOSTER FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2012
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
51185 WILLIS RD
BELLEVILLE MI
48111-9394
US
IV. Provider business mailing address
51185 WALLIS ROAD
BELLEVILLE MI
48111-9394
US
V. Phone/Fax
- Phone: 734-276-7909
- Fax: 734-780-7401
- Phone: 734-276-7906
- Fax: 734-677-8517
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | 6801063713 |
| License Number State | MI |
VIII. Authorized Official
Name:
SHARI
ANN
FOSTER
Title or Position: CEO, OWNER
Credential: LMSW
Phone: 734-276-7906