Provider Demographics
NPI:1467668673
Name:VOCATIONAL INDEPENDENCE PROGRAM
Entity Type:Organization
Organization Name:VOCATIONAL INDEPENDENCE PROGRAM
Other - Org Name:GENESEE COUNTY ASSOC. FOR RETARDED CITIZENS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:INFORMATION SYSTEMS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DOLLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-238-3671
Mailing Address - Street 1:5069 VAN SLYKE RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3959
Mailing Address - Country:US
Mailing Address - Phone:810-238-3671
Mailing Address - Fax:810-238-2140
Practice Address - Street 1:5069 VAN SLYKE RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3959
Practice Address - Country:US
Practice Address - Phone:810-238-3671
Practice Address - Fax:810-238-2140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services