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General NPI Number Information
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NPI Number | 1063409480
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Entity Type | Organization
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Legal Business Name | LUTHERAN CHILD AND FAMILY SERVICE OF MICHIGAN
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 6019 WESTSIDE SAGINAW RD
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City | BAY CITY
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State | MI
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Zip | 48706-9357
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Country | US
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Telephone | 989-686-7650
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Fax | 989-686-7688
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Provider Business Mailing Address
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Address Line | 6019 WESTSIDE SAGINAW RD P.O. BOX 48
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City | BAY CITY
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State | MI
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Zip | 48706-9357
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Country | US
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Telephone | 989-686-7650
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Fax | 989-686-7688
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Authorized Official
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Title or Position | ACCOUNTING CLERK
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Name | MS. JANINE A JANKOWSKI
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Credential |
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Telephone | 989-686-7650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 4422590
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License Number State | MI
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