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General NPI Number Information
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NPI Number | 1033264890
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Entity Type | Organization
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Legal Business Name | JUDSON CENTER, INC.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 06/21/2023
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Provider Practice Location Address
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Address Line | 4410 W 13 MILE RD
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City | ROYAL OAK
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State | MI
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Zip | 48073-6515
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Country | US
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Telephone | 248-549-4339
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Fax | 248-549-8955
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Provider Business Mailing Address
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Address Line | 4410 W 13 MILE RD
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City | ROYAL OAK
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State | MI
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Zip | 48073-6515
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Country | US
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Telephone | 248-549-4339
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Fax | 248-549-8955
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MS. LAURA HOUT
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Credential | MS, LLP
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Telephone | 248-549-4339
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 6772767
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 6359520
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | MI
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Taxonomy #8
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State | MI
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Taxonomy #9
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State | MI
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Taxonomy #10
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | MI
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