Provider Demographics
NPI:1538917851
Name:CHILD AND FAMILY SERVICES NORTHEAST MICHIGAN
Entity type:Organization
Organization Name:CHILD AND FAMILY SERVICES NORTHEAST MICHIGAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DETTLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-255-3317
Mailing Address - Street 1:1044 US HIGHWAY 23 N
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-1262
Mailing Address - Country:US
Mailing Address - Phone:989-255-3317
Mailing Address - Fax:
Practice Address - Street 1:1044 US HIGHWAY 23 N
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1262
Practice Address - Country:US
Practice Address - Phone:198-935-6456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-10
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No253J00000XAgenciesFoster Care AgencyGroup - Multi-Specialty
No374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty