Provider Demographics
NPI:1881837110
Name:AREA AGENCY ON AGING 1-B
Entity Type:Organization
Organization Name:AREA AGENCY ON AGING 1-B
Other - Org Name:AGEWAYS NONPROFIT SENIOR SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KARSON
Authorized Official - Suffix:
Authorized Official - Credentials:DHA, MBA
Authorized Official - Phone:248-709-2121
Mailing Address - Street 1:29100 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1046
Mailing Address - Country:US
Mailing Address - Phone:248-357-2255
Mailing Address - Fax:248-948-9691
Practice Address - Street 1:29100 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 400
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1046
Practice Address - Country:US
Practice Address - Phone:248-357-2255
Practice Address - Fax:248-948-9691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-16
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4509351Medicaid