Provider Demographics
NPI:1366789224
Name:FAMILY SERVICES
Entity type:Organization
Organization Name:FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VNA THEARPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONIQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-802-1591
Mailing Address - Street 1:20420 ROSCOMMON ST
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-2259
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19855 OUTER DR
Practice Address - Street 2:STE.104
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2022
Practice Address - Country:US
Practice Address - Phone:313-274-5840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health