Provider Demographics
NPI:1265685663
Name:GOODWILL INDUSTRIES OF MID MICHIGAN
Entity Type:Organization
Organization Name:GOODWILL INDUSTRIES OF MID MICHIGAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WFD DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-762-9960
Mailing Address - Street 1:501 S AVERILL AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48506-4009
Mailing Address - Country:US
Mailing Address - Phone:810-762-9960
Mailing Address - Fax:810-762-9957
Practice Address - Street 1:501 S AVERILL AVE
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48506-4009
Practice Address - Country:US
Practice Address - Phone:810-762-9960
Practice Address - Fax:810-762-9957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services