Provider Demographics
NPI:1598173635
Name:CENTER FOR WORK AND LIFE, LLC
Entity Type:Organization
Organization Name:CENTER FOR WORK AND LIFE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCAIL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:WUCHERER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, ACSW
Authorized Official - Phone:734-669-7202
Mailing Address - Street 1:1919 PEPPERMILL WAY
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-4531
Mailing Address - Country:US
Mailing Address - Phone:734-669-7202
Mailing Address - Fax:888-581-9066
Practice Address - Street 1:1919 PEPPERMILL WAY
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-4531
Practice Address - Country:US
Practice Address - Phone:734-669-7202
Practice Address - Fax:888-581-9066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010337521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty