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General NPI Number Information
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NPI Number | 1376812164
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Entity Type | Organization
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Legal Business Name | KIRBY'S ADULT FOSTER CARE SERVICES INC.
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Dates
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Enumeration Date | 12/22/2011
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Last Update Date | 12/22/2011
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Provider Practice Location Address
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Address Line | 2285 E LILY LAKE RD
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City | HARRISON
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State | MI
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Zip | 48625-7447
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Country | US
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Telephone | 989-539-7365
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Fax | 989-630-0276
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Provider Business Mailing Address
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Address Line | 290 BIRCH ST
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City | HARRISON
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State | MI
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Zip | 48625-9056
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Country | US
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Telephone | 989-430-8061
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Fax | 989-630-0276
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MICHAEL JAMES KIRBY II
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Credential |
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Telephone | 989-430-8061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number | AS180308851
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License Number State | MI
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