Provider Demographics
NPI:1316288186
Name:FIRSTPLAN MATERNAL INFANT SERVICES, LLC
Entity type:Organization
Organization Name:FIRSTPLAN MATERNAL INFANT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:EMANUEL
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-835-9700
Mailing Address - Street 1:48795 MICHAYWE DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48044-2308
Mailing Address - Country:US
Mailing Address - Phone:248-835-9700
Mailing Address - Fax:
Practice Address - Street 1:48795 MICHAYWE DR
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48044-2308
Practice Address - Country:US
Practice Address - Phone:248-835-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801087640251300000X, 251S00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251300000XAgenciesLocal Education Agency (LEA)
No251S00000XAgenciesCommunity/Behavioral Health