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General NPI Number Information
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NPI Number | 1437688975
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Entity Type | Organization
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Legal Business Name | RAISING COMMUNITIES ADULT SOCIAL SERVICES
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3424 WINCHESTER RD
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-2469
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Country | US
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Telephone | 248-432-7740
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Fax |
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Provider Business Mailing Address
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Address Line | 3424 WINCHESTER RD
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-2469
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Country | US
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Telephone | 248-432-7740
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KIMBERLY GARNER-LUCAS
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Credential |
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Telephone | 248-862-5942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6801010825
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License Number State | MI
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