Provider Demographics
NPI:1063025096
Name:KADE, JOIE NIKOLE
Entity Type:Individual
Prefix:
First Name:JOIE
Middle Name:NIKOLE
Last Name:KADE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10579 W COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:MI
Mailing Address - Zip Code:49310-9285
Mailing Address - Country:US
Mailing Address - Phone:989-818-2917
Mailing Address - Fax:
Practice Address - Street 1:623 W WARWICK DR STE 2
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1177
Practice Address - Country:US
Practice Address - Phone:989-285-1490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician