MEDICARE: LUTHERAN CHILD AND FAMILY SERVICE OF MICHIGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	4422590	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063409480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUTHERAN CHILD AND FAMILY SERVICE OF MICHIGAN

Provider Business Mailing Address
First Line	:	6019 WESTSIDE SAGINAW RD
Second Line	:	P.O. BOX 48
City	:	BAY CITY
State	:	MI
Zip	:	48706-9357
Country	:	US
Telephone Number	:	989-686-7650
Fax Number	:	989-686-7688

Provider Business Practice Location Address
First Line	:	6019 WESTSIDE SAGINAW RD
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-9357
Country	:	US
Telephone Number	:	989-686-7650
Fax Number	:	989-686-7688

Authorized Official
Title or Position	:	ACCOUNTING CLERK
Name	:	MS. JANINE A JANKOWSKI
Credential	:
Telephone Number	:	989-686-7650

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	11/02/2007

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Directions to “LUTHERAN CHILD AND FAMILY SERVICE OF MICHIGAN ” Practice Location

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