MEDICARE: FAMILY COUNSELING & SHELTER SERVICES

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	822044	MI

General Provider Information

NPI Number	:	1912181322
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY COUNSELING & SHELTER SERVICES

Provider Business Mailing Address
First Line	:	14930 LAPLAISANCE RD STE 106
Second Line	:
City	:	MONROE
State	:	MI
Zip	:	48161-3871
Country	:	US
Telephone Number	:	734-241-0180
Fax Number	:	734-241-8259

Provider Business Practice Location Address
First Line	:	14930 LAPLAISANCE RD STE 106
Second Line	:
City	:	MONROE
State	:	MI
Zip	:	48161-3871
Country	:	US
Telephone Number	:	734-241-0180
Fax Number	:	734-241-8259

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	KATHRYN K. SLUSHER
Credential	:
Telephone Number	:	734-241-0180

Provider Enumeration Date	:	12/20/2007
Last Update Date	:	11/09/2012

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