Provider Demographics
NPI:1306944848
Name:THE INFORMATION CENTER, INC., THE FAMILY RESOURCE PLACE
Entity type:Organization
Organization Name:THE INFORMATION CENTER, INC., THE FAMILY RESOURCE PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:D'ANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-287-7888
Mailing Address - Street 1:20400 SUPERIOR RD
Mailing Address - Street 2:THE INFORMATION CENTER
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-5362
Mailing Address - Country:US
Mailing Address - Phone:734-282-7171
Mailing Address - Fax:734-282-7105
Practice Address - Street 1:20400 SUPERIOR RD
Practice Address - Street 2:THE INFORMATION CENTER
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-5362
Practice Address - Country:US
Practice Address - Phone:734-282-7171
Practice Address - Fax:734-282-7105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4508971Medicaid