Organization · NPI-2

Family Service INC

Health Maintenance Organization · Detroit, MI

NPI number1619285533
StatusActive
Last updated in NPPESSep 14, 2010

Details

NPI
1619285533
Entity type
Organization (NPI-2)
Legal business name
Family Service INC
Organization subpart
No
Enumeration date
Sep 14, 2010
Last updated
Sep 14, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
302R00000X Health Maintenance Organization6801081677MIYes
305R00000X Preferred Provider Organization6801081677MI

Practice location

10900 Harper Ave
Detroit, MI 48213-3364

Phone 313-579-5989

Mailing address

10900 Harper Ave
Detroit, MI 48213-3364

Phone 313-579-5989

Authorized official

Virdell Thomas
Director
3135795989

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