Provider Demographics
NPI:1982036497
Name:FAMILY SERVICE INC.
Entity Type:Organization
Organization Name:FAMILY SERVICE INC.
Other - Org Name:FAMILY SERVICE OF DETROIT AND WAYNE COUNTY
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:LLP
Authorized Official - Phone:3132-745-8740
Mailing Address - Street 1:120 PARSONS ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2002
Mailing Address - Country:US
Mailing Address - Phone:313-579-5989
Mailing Address - Fax:
Practice Address - Street 1:5690 CECIL ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48210-1964
Practice Address - Country:US
Practice Address - Phone:313-579-5989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI101Y00000X, 101YS0200X, 104100000X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty