Provider Demographics
NPI:1851511562
Name:AMERICAN INDIAN SERVICES, INC.
Entity Type:Organization
Organization Name:AMERICAN INDIAN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:FAY
Authorized Official - Last Name:GIVENS
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:313-388-4100
Mailing Address - Street 1:1110 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146-2409
Mailing Address - Country:US
Mailing Address - Phone:313-388-4100
Mailing Address - Fax:313-388-6566
Practice Address - Street 1:1110 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-2409
Practice Address - Country:US
Practice Address - Phone:313-388-4100
Practice Address - Fax:313-388-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3119549251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3119549Medicaid