MEDICARE: JARC

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	AS630012603	MI

General Provider Information

NPI Number	:	1285177972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JARC

Provider Business Mailing Address
First Line	:	30301 NORTHWESTERN HWY
Second Line	:	SUITE 100
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3214
Country	:	US
Telephone Number	:	248-538-6611
Fax Number	:

Provider Business Practice Location Address
First Line	:	24245 BROADVIEW ST
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-1807
Country	:	US
Telephone Number	:	248-538-6611
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MELISSA STEWART
Credential	:	LMSW
Telephone Number	:	248-488-7537

Provider Enumeration Date	:	11/29/2016
Last Update Date	:	11/29/2016

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