=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275294787
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MACFARLAND GROUP INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/06/2022
-----------------------------------------------------
Last Update Date | 11/28/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 650 CHURCH ST
-----------------------------------------------------
City | PLYMOUTH
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48170-1689
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-335-0672
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16575 HARRISON ST
-----------------------------------------------------
City | LIVONIA
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 48154-3413
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 734-674-6916
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | DR. MARICRIS MACFARLAND
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 734-674-6716
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------