Provider Demographics
NPI:1013215151
Name:ONE STEP FORWARD SIL HOUSING COMPANY
Entity Type:Organization
Organization Name:ONE STEP FORWARD SIL HOUSING COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-571-4423
Mailing Address - Street 1:2711 E JEFFERSON AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-4105
Mailing Address - Country:US
Mailing Address - Phone:313-571-4423
Mailing Address - Fax:
Practice Address - Street 1:2711 E JEFFERSON AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-4105
Practice Address - Country:US
Practice Address - Phone:313-571-4423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-13
Last Update Date:2011-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care