MEDICARE: FAMILY SERVICE

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		MI

General Provider Information

NPI Number	:	1508299694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY SERVICE

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	:

Provider Business Practice Location Address
First Line	:	3950 TOLEDO ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48216-1061
Country	:	US
Telephone Number	:	313-579-5989
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DEBORAH M SNYDER
Credential	:	LLP
Telephone Number	:	313-274-5840

Provider Enumeration Date	:	08/13/2013
Last Update Date	:	08/13/2013

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Directions to “FAMILY SERVICE ” Practice Location

Language	Start Address	Practice Location

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