Provider Demographics
NPI:1093783052
Name:KEY DEVELOPMENT CENTER, INC.
Entity Type:Organization
Organization Name:KEY DEVELOPMENT CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KING-HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CADC,CSS,CPS
Authorized Official - Phone:810-220-8192
Mailing Address - Street 1:2060 GRAND RIVER ANX STE 600
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-5312
Mailing Address - Country:US
Mailing Address - Phone:810-220-8192
Mailing Address - Fax:
Practice Address - Street 1:2060 GRAND RIVER ANX STE 600
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-5312
Practice Address - Country:US
Practice Address - Phone:810-220-8192
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI470055101YA0400X
MI4700057251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty