Provider Demographics
NPI:1275775124
Name:WASHTENAW COUNTY GOVERNMENT
Entity Type:Organization
Organization Name:WASHTENAW COUNTY GOVERNMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BELKNAP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-544-2958
Mailing Address - Street 1:555 TOWNER ST
Mailing Address - Street 2:PO BOX 915
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5752
Mailing Address - Country:US
Mailing Address - Phone:734-544-6700
Mailing Address - Fax:734-544-6704
Practice Address - Street 1:555 TOWNER ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5752
Practice Address - Country:US
Practice Address - Phone:734-544-6700
Practice Address - Fax:734-544-6704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-24
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5324164Medicaid
MI5324164Medicaid