Provider Demographics
NPI:1104876689
Name:TEACHING FAMILY HOMES
Entity type:Organization
Organization Name:TEACHING FAMILY HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:906-249-5437
Mailing Address - Street 1:1000 SILVER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-8948
Mailing Address - Country:US
Mailing Address - Phone:906-249-5437
Mailing Address - Fax:906-249-5438
Practice Address - Street 1:1000 SILVER CREEK RD
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-8948
Practice Address - Country:US
Practice Address - Phone:906-249-5437
Practice Address - Fax:906-249-5438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P31790Medicare PIN