Provider Demographics
NPI:1417257106
Name:MID MICHIGAN COMMUNITY ACTION AGENCY
Entity Type:Organization
Organization Name:MID MICHIGAN COMMUNITY ACTION AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EARLY CHILDHOOD SERVICES DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-832-7310
Mailing Address - Street 1:1521 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-5685
Mailing Address - Country:US
Mailing Address - Phone:989-832-7310
Mailing Address - Fax:
Practice Address - Street 1:1521 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-5685
Practice Address - Country:US
Practice Address - Phone:989-832-7310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-27
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable