Healthcare Provider Details

I. General information

NPI: 1447816707
Provider Name (Legal Business Name): BASELINE HUMAN & EDUCATIONAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29615 GREENING ST
FARMINGTON HILLS MI
48334-2245
US

IV. Provider business mailing address

PO BOX 2792
SOUTHFIELD MI
48037-2792
US

V. Phone/Fax

Practice location:
  • Phone: 248-761-5559
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM T CARTER
Title or Position: ADMINISTRATOR
Credential:
Phone: 248-761-5559