MEDICARE: FAMILY SERVICE INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor
3	251S00000X	Community/Behavioral Health Agency
4	101YS0200X	School Counselor

General Provider Information

NPI Number	:	1386086262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY SERVICE INC

Provider Business Mailing Address
First Line	:	120 PARSONS ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-2002
Country	:	US
Telephone Number	:	313-579-5989
Fax Number	:	313-831-9139

Provider Business Practice Location Address
First Line	:	3030 FAIRVIEW ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48214-2215
Country	:	US
Telephone Number	:	313-866-4500
Fax Number	:

Authorized Official
Title or Position	:	EXECUTICE DIRECTOR
Name	:	DEBORAH SNYDER
Credential	:	MA, LLP
Telephone Number	:	12489904337

Provider Enumeration Date	:	07/22/2013
Last Update Date	:	07/22/2013

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Directions to “FAMILY SERVICE INC ” Practice Location

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