Provider Demographics
NPI:1679016398
Name:JARC
Entity Type:Organization
Organization Name:JARC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-488-7537
Mailing Address - Street 1:30301 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3214
Mailing Address - Country:US
Mailing Address - Phone:248-538-6611
Mailing Address - Fax:
Practice Address - Street 1:6103 ORCHARD LAKE RD
Practice Address - Street 2:#104
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2308
Practice Address - Country:US
Practice Address - Phone:248-538-6611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health