Provider Demographics
NPI:1376812164
Name:KIRBY'S ADULT FOSTER CARE SERVICES INC.
Entity type:Organization
Organization Name:KIRBY'S ADULT FOSTER CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KIRBY II
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-430-8061
Mailing Address - Street 1:290 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:MI
Mailing Address - Zip Code:48625-9056
Mailing Address - Country:US
Mailing Address - Phone:989-430-8061
Mailing Address - Fax:989-630-0276
Practice Address - Street 1:2285 E LILY LAKE RD
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:MI
Practice Address - Zip Code:48625-7447
Practice Address - Country:US
Practice Address - Phone:989-539-7365
Practice Address - Fax:989-630-0276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS180308851305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service