Provider Demographics
NPI:1699861609
Name:FAMILY SERVICE AND CHILDRENS AID
Entity type:Organization
Organization Name:FAMILY SERVICE AND CHILDRENS AID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PROCTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-787-7920
Mailing Address - Street 1:330 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-2121
Mailing Address - Country:US
Mailing Address - Phone:517-787-7920
Mailing Address - Fax:517-787-2440
Practice Address - Street 1:330 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2121
Practice Address - Country:US
Practice Address - Phone:517-787-7920
Practice Address - Fax:517-787-2440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI138213OtherCARE CHOICES
MI398186150OtherTRICARE DR S ONLY
MI0056OtherHEALTH PLAN OF MI
MIFAMIL-6361OtherCOMPCARE
MI138213OtherPREFFERED CHOICES
MI260078000OtherMAGELLAN EAP CAROL ONLY
MIFC-ADR-BF-122763OtherGREAT LAKES
MI1105443OtherCONNECTICUT GENERAL
MIM#38002OtherM-CARE
MI750910682OtherBLUE CROSS BLUE SHIELD
MIP50798OtherGREAT LAKES
MI398186150OtherTRICARE DR S ONLY