Provider Demographics
NPI:1184358673
Name:HOLDING A SPACE
Entity type:Organization
Organization Name:HOLDING A SPACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DUNNING
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:810-625-3434
Mailing Address - Street 1:6128 RICH ST
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-8930
Mailing Address - Country:US
Mailing Address - Phone:810-625-3434
Mailing Address - Fax:
Practice Address - Street 1:6128 RICH ST
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-8930
Practice Address - Country:US
Practice Address - Phone:810-625-3434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty