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General NPI Number Information
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NPI Number | 1619796398
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Entity Type | Organization
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Legal Business Name | NEIGHBORHOOD SERVICE ORGANIZATION
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 3426 MACK AVE
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City | DETROIT
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State | MI
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Zip | 48207-2315
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Country | US
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Telephone | 888-360-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 882 OAKMAN BLVD STE C
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City | DETROIT
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State | MI
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Zip | 48238-4019
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Country | US
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Telephone | 313-305-0294
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REIMBURSEMENT
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Name | JULIE HERZIG
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Credential |
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Telephone | 313-961-4890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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