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General NPI Number Information
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NPI Number | 1639520562
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Entity Type | Organization
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Legal Business Name | FAMILY MATTERS II
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Dates
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Enumeration Date | 06/22/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 14550 WESTWOOD ST
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City | DETROIT
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State | MI
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Zip | 48223-2251
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Country | US
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Telephone | 248-882-5520
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Fax |
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Provider Business Mailing Address
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Address Line | 14550 WESTWOOD ST
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City | DETROIT
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State | MI
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Zip | 48223-2251
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Country | US
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Telephone | 248-882-5520
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Fax |
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Authorized Official
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Title or Position | COORDINATOR
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Name | CONSTANCE BROWN
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Credential | LBSW
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Telephone | 248-882-5520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State | MI
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