Provider Demographics
NPI:1669006623
Name:ASSURED FAMILY SERVICES
Entity Type:Organization
Organization Name:ASSURED FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ICSB COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-585-8075
Mailing Address - Street 1:7310 WOODWARD AVE STE 601
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3165
Mailing Address - Country:US
Mailing Address - Phone:313-485-9734
Mailing Address - Fax:
Practice Address - Street 1:7310 WOODWARD AVE STE 601
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3165
Practice Address - Country:US
Practice Address - Phone:313-485-9734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management