Provider Demographics
NPI:1114135191
Name:THE GUIDANCE CENTER
Entity Type:Organization
Organization Name:THE GUIDANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACT ADVOCATE
Authorized Official - Prefix:MS
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:STADER
Authorized Official - Suffix:
Authorized Official - Credentials:LLMSW
Authorized Official - Phone:734-785-7705
Mailing Address - Street 1:16751 BARBERRY ST APT B5
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-1551
Mailing Address - Country:US
Mailing Address - Phone:734-281-1982
Mailing Address - Fax:
Practice Address - Street 1:19275 NORTHLINE RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2220
Practice Address - Country:US
Practice Address - Phone:734-785-7705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801088571251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health