Provider Demographics
NPI:1568032837
Name:FOSTERING FUTURES
Entity Type:Organization
Organization Name:FOSTERING FUTURES
Other - Org Name:FOSTERING FUTURES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:C
Authorized Official - Last Name:DEVIVO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:734-864-6879
Mailing Address - Street 1:2008 HOGBACK RD STE 6
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9751
Mailing Address - Country:US
Mailing Address - Phone:734-481-8999
Mailing Address - Fax:734-369-3291
Practice Address - Street 1:2008 HOGBACK RD STE 6
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9751
Practice Address - Country:US
Practice Address - Phone:734-481-8999
Practice Address - Fax:734-369-3291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No253J00000XAgenciesFoster Care Agency