Provider Demographics
NPI:1720895139
Name:JUDSON CENTER, INC.
Entity type:Organization
Organization Name:JUDSON CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENTS
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:MENDOZA
Authorized Official - Last Name:MCNAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-837-2092
Mailing Address - Street 1:30301 NORTHWESTERN HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3277
Mailing Address - Country:US
Mailing Address - Phone:866-558-3766
Mailing Address - Fax:248-554-6518
Practice Address - Street 1:12200 E 13 MILE RD STE 200
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3093
Practice Address - Country:US
Practice Address - Phone:866-558-3766
Practice Address - Fax:586-573-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health