Provider Demographics
NPI:1093152092
Name:HOLY CROSS YOUTH AND FAMILY SERVICES INC
Entity Type:Organization
Organization Name:HOLY CROSS YOUTH AND FAMILY SERVICES INC
Other - Org Name:KAIROS HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUDOUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-596-3558
Mailing Address - Street 1:8759 CLINTON MACON RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MI
Mailing Address - Zip Code:49236-9572
Mailing Address - Country:US
Mailing Address - Phone:517-423-7556
Mailing Address - Fax:517-423-5442
Practice Address - Street 1:2084 HEMMETER RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-3943
Practice Address - Country:US
Practice Address - Phone:989-401-7506
Practice Address - Fax:989-401-7509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI730232324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility