Provider Demographics
NPI:1154681641
Name:AFFIRMATIONS LESBIAN GAY COMMUNITY CENTER INC
Entity Type:Organization
Organization Name:AFFIRMATIONS LESBIAN GAY COMMUNITY CENTER INC
Other - Org Name:AFFIRMATIONS COMMUNITY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:MERKLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-412-8112
Mailing Address - Street 1:290 WEST 9 MILE ROAD
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220
Mailing Address - Country:US
Mailing Address - Phone:248-398-7105
Mailing Address - Fax:248-541-1943
Practice Address - Street 1:290 WEST 9 MILE ROAD
Practice Address - Street 2:
Practice Address - City:FERNDALE
Practice Address - State:MI
Practice Address - Zip Code:48220
Practice Address - Country:US
Practice Address - Phone:248-398-7105
Practice Address - Fax:248-541-1943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-18
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health