Provider Demographics
NPI:1083136840
Name:FAMILY LIVING CENTER, INC.
Entity Type:Organization
Organization Name:FAMILY LIVING CENTER, INC.
Other - Org Name:N/A
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:R.
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-334-5330
Mailing Address - Street 1:132 FRANKLIN BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48341-1778
Mailing Address - Country:US
Mailing Address - Phone:248-334-5330
Mailing Address - Fax:248-334-1457
Practice Address - Street 1:132 FRANKLIN BLVD STE 101
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-1778
Practice Address - Country:US
Practice Address - Phone:248-334-5330
Practice Address - Fax:248-334-1457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS630012322253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency