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General NPI Number Information
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NPI Number | 1093783052
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Entity Type | Organization
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Legal Business Name | KEY DEVELOPMENT CENTER, INC.
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 02/05/2014
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Provider Practice Location Address
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Address Line | 2060 GRAND RIVER ANX STE 600
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City | BRIGHTON
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State | MI
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Zip | 48114-5312
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Country | US
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Telephone | 810-220-8192
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Fax |
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Provider Business Mailing Address
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Address Line | 2060 GRAND RIVER ANX STE 600
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City | BRIGHTON
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State | MI
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Zip | 48114-5312
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Country | US
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Telephone | 810-220-8192
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ANNE M. KING-HUDSON
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Credential | MA, CADC,CSS,CPS
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Telephone | 810-220-8192
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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 | 4700057
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 470055
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License Number State | MI
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