Healthcare Provider Details

I. General information

NPI: 1205702891
Provider Name (Legal Business Name): MSU EARLY LEARNING INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 E CESAR E CHAVEZ AVE
LANSING MI
48906-5457
US

IV. Provider business mailing address

10904 JORDAN RD
LAKE ODESSA MI
48849-9451
US

V. Phone/Fax

Practice location:
  • Phone: 517-355-1734
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: RACHELLE NEFF
Title or Position: BEHAVIOR TECHNICIAN
Credential:
Phone: 616-828-9134