Healthcare Provider Details

I. General information

NPI: 1306944848
Provider Name (Legal Business Name): THE INFORMATION CENTER, INC., THE FAMILY RESOURCE PLACE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 11/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20400 SUPERIOR RD THE INFORMATION CENTER
TAYLOR MI
48180-5362
US

IV. Provider business mailing address

20400 SUPERIOR RD THE INFORMATION CENTER
TAYLOR MI
48180-5362
US

V. Phone/Fax

Practice location:
  • Phone: 734-282-7171
  • Fax: 734-282-7105
Mailing address:
  • Phone: 734-282-7171
  • Fax: 734-282-7105

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: EDWARD D'ANGELO
Title or Position: PRESIDENT CEO
Credential: LMSW
Phone: 734-287-7888