Provider Demographics
NPI:1578075156
Name:THE ARC GROSSE POINTE HARPER WOODS
Entity Type:Organization
Organization Name:THE ARC GROSSE POINTE HARPER WOODS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:COOPER
Authorized Official - Last Name:MOFFAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-457-8588
Mailing Address - Street 1:20475 SUNNINGDALE PARK
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1637
Mailing Address - Country:US
Mailing Address - Phone:586-457-8588
Mailing Address - Fax:313-884-2821
Practice Address - Street 1:20475 SUNNINGDALE PARK
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-1637
Practice Address - Country:US
Practice Address - Phone:586-457-8588
Practice Address - Fax:313-884-2821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-03
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable