Provider Demographics
NPI:1689947996
Name:HOLY CROSS YOUTH AND FAMILY SERVICES
Entity Type:Organization
Organization Name:HOLY CROSS YOUTH AND FAMILY SERVICES
Other - Org Name:KAIROS HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL OFFICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUDOUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-596-3558
Mailing Address - Street 1:8759 CLINTON MACON RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MI
Mailing Address - Zip Code:49236-9572
Mailing Address - Country:US
Mailing Address - Phone:517-423-7556
Mailing Address - Fax:517-423-5442
Practice Address - Street 1:3400 S WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-4958
Practice Address - Country:US
Practice Address - Phone:989-755-1702
Practice Address - Fax:989-755-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI730230324500000X
MISA0250383324500000X
MISA0330349324500000X
MISA0090080324500000X
MI7302293245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility