Provider Demographics
NPI:1275785602
Name:LAPEER TEAM WORK, INC
Entity Type:Organization
Organization Name:LAPEER TEAM WORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-664-2710
Mailing Address - Street 1:PO BOX 294
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-0294
Mailing Address - Country:US
Mailing Address - Phone:810-664-2710
Mailing Address - Fax:810-664-2122
Practice Address - Street 1:1785 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-1719
Practice Address - Country:US
Practice Address - Phone:810-664-2710
Practice Address - Fax:810-664-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services