Healthcare Provider Details

I. General information

NPI: 1649395849
Provider Name (Legal Business Name): PROFESSIONAL CONSULTING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 W EUCLID AVE
JACKSON MI
49203-4102
US

IV. Provider business mailing address

306 W MICHIGAN AVE
JACKSON MI
49201-2121
US

V. Phone/Fax

Practice location:
  • Phone: 517-768-9200
  • Fax:
Mailing address:
  • Phone: 517-768-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL E. JOHNSON
Title or Position: CEO
Credential:
Phone: 517-768-9200