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General NPI Number Information
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NPI Number | 1427867340
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Entity Type | Organization
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Legal Business Name | CHILDREN AND YOUNG ADULT SERVICES
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 39514 ROCKCREST LN
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City | NORTHVILLE
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State | MI
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Zip | 48168-3960
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Country | US
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Telephone | 810-494-1673
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Fax |
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Provider Business Mailing Address
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Address Line | 47526 CLIPPER ST UNIT 1254
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City | PLYMOUTH
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State | MI
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Zip | 48170-7166
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Country | US
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Telephone | 810-494-1673
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER SIBERT
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Credential |
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Telephone | 248-910-7396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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