Provider Demographics
NPI:1437688975
Name:RAISING COMMUNITIES ADULT SOCIAL SERVICES
Entity Type:Organization
Organization Name:RAISING COMMUNITIES ADULT SOCIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARNER-LUCAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-862-5942
Mailing Address - Street 1:3424 WINCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2469
Mailing Address - Country:US
Mailing Address - Phone:248-432-7740
Mailing Address - Fax:
Practice Address - Street 1:3424 WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2469
Practice Address - Country:US
Practice Address - Phone:248-432-7740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010108251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty