Provider Demographics
NPI:1538313085
Name:LOVEJOY SPECIAL NEEDS CENTER CORPORATION
Entity Type:Organization
Organization Name:LOVEJOY SPECIAL NEEDS CENTER CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-803-3655
Mailing Address - Street 1:2820 WOODVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-1727
Mailing Address - Country:US
Mailing Address - Phone:517-803-3655
Mailing Address - Fax:517-346-7705
Practice Address - Street 1:17101 DOLORES ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3856
Practice Address - Country:US
Practice Address - Phone:734-838-0843
Practice Address - Fax:734-838-0842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS820294204320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities