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General NPI Number Information
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NPI Number | 1649717265
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Entity Type | Organization
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Legal Business Name | VOLUNTEERS OF AMERICA MICHIGAN
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Dates
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Enumeration Date | 01/20/2017
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Last Update Date | 01/25/2017
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Provider Practice Location Address
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Address Line | 414 N LARCH ST
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City | LANSING
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State | MI
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Zip | 48912-1208
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Country | US
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Telephone | 517-489-5277
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Fax |
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Provider Business Mailing Address
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Address Line | 414 N LARCH ST
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City | LANSING
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State | MI
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Zip | 48912-1208
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Country | US
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Telephone | 517-489-5277
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | PATRICK JOHN PATTERSON
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Credential |
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Telephone | 517-489-5277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1750700456
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1184760365
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1316067002
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 1295280022
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1952380412
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License Number State | MI
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