Provider Demographics
NPI:1922513902
Name:JOSHUA STREET RESIDENTIAL CARE & REHABILITATIVE SERVICES
Entity Type:Organization
Organization Name:JOSHUA STREET RESIDENTIAL CARE & REHABILITATIVE SERVICES
Other - Org Name:JOSHUA STREET RESIDENTIAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KATREVA
Authorized Official - Middle Name:N
Authorized Official - Last Name:BISBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-882-3544
Mailing Address - Street 1:PO BOX 1362
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48826-1362
Mailing Address - Country:US
Mailing Address - Phone:517-882-3544
Mailing Address - Fax:517-882-3525
Practice Address - Street 1:809 CENTER ST STE 9A
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-5258
Practice Address - Country:US
Practice Address - Phone:517-882-3544
Practice Address - Fax:517-882-3525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-12
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities