Provider Demographics
NPI:1619934650
Name:NORSERV GROUP LTD
Entity Type:Organization
Organization Name:NORSERV GROUP LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:FRASER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:810-329-4798
Mailing Address - Street 1:1322 NORTH RIVER ROAD
Mailing Address - Street 2:NORSERV GROUP LTD
Mailing Address - City:ST CLAIR
Mailing Address - State:MI
Mailing Address - Zip Code:48079
Mailing Address - Country:US
Mailing Address - Phone:810-329-4798
Mailing Address - Fax:810-329-7303
Practice Address - Street 1:1322 NORTH RIVER ROAD
Practice Address - Street 2:NORSERV GROUP LTD
Practice Address - City:ST CLAIR
Practice Address - State:MI
Practice Address - Zip Code:48079
Practice Address - Country:US
Practice Address - Phone:810-329-4798
Practice Address - Fax:810-329-7303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty