Provider Demographics
NPI:1558522136
Name:INTAKE, ASSESSMENT AND REFERRAL CENTER, INC.
Entity type:Organization
Organization Name:INTAKE, ASSESSMENT AND REFERRAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:BIELSKIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA,MBA,CAAC,CCSR
Authorized Official - Phone:810-235-9555
Mailing Address - Street 1:1047 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3636
Mailing Address - Country:US
Mailing Address - Phone:810-235-9555
Mailing Address - Fax:810-235-9525
Practice Address - Street 1:1047 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3636
Practice Address - Country:US
Practice Address - Phone:810-235-9555
Practice Address - Fax:810-235-9525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI250033251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable