=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124209929
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EAI EMPLOYMENT RESOURCES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2007
-----------------------------------------------------
Last Update Date | 11/20/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23015 ECORSE RD
-----------------------------------------------------
City | TAYLOR
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48180-1866
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-292-2713
-----------------------------------------------------
Fax | 313-291-2740
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23015 ECORSE RD
-----------------------------------------------------
City | TAYLOR
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48180-1866
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 313-292-2713
-----------------------------------------------------
Fax | 313-291-2740
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | MRS. CAROLYN DENISE SLOAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 313-291-2713
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------