Provider Demographics
NPI:1003298191
Name:DEPARTMENT OF HEALTH AND HUMAN SERVICES
Entity type:Organization
Organization Name:DEPARTMENT OF HEALTH AND HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUGGENBUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-887-9712
Mailing Address - Street 1:5330 W MICHIGAN AVE
Mailing Address - Street 2:APT 102
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-3364
Mailing Address - Country:US
Mailing Address - Phone:517-219-3334
Mailing Address - Fax:
Practice Address - Street 1:5330 W MICHIGAN AVE
Practice Address - Street 2:APT 102
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-3364
Practice Address - Country:US
Practice Address - Phone:517-219-3334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-24
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIT326398630047305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service