Provider Demographics
NPI:1154771566
Name:ETRS(EDUCATION TRAINING RESEARCH SERVICES)
Entity type:Organization
Organization Name:ETRS(EDUCATION TRAINING RESEARCH SERVICES)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GITZEN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:248-399-2600
Mailing Address - Street 1:25600 WOODWARD AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-0943
Mailing Address - Country:US
Mailing Address - Phone:248-399-2600
Mailing Address - Fax:248-399-2606
Practice Address - Street 1:38099 SCHOOLCRAFT RD
Practice Address - Street 2:SUITE 127
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1029
Practice Address - Country:US
Practice Address - Phone:734-462-3096
Practice Address - Fax:734-462-0316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty