Provider Demographics
NPI:1336527571
Name:FIRSTPLAN HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:FIRSTPLAN HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:EMANUEL
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-579-9791
Mailing Address - Street 1:148 S MAIN ST STE 103C
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-7900
Mailing Address - Country:US
Mailing Address - Phone:248-579-9791
Mailing Address - Fax:586-229-2874
Practice Address - Street 1:148 S MAIN ST STE 103C
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-7900
Practice Address - Country:US
Practice Address - Phone:248-579-9791
Practice Address - Fax:586-229-2874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010876401041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty