Provider Demographics
NPI:1457726341
Name:BERNARD BALL AND ASSOC INC
Entity type:Organization
Organization Name:BERNARD BALL AND ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BALL
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-570-0974
Mailing Address - Street 1:PO BOX 66104
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-6104
Mailing Address - Country:US
Mailing Address - Phone:313-570-0974
Mailing Address - Fax:586-362-8803
Practice Address - Street 1:12200 E 13 MILE RD STE 150
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-3096
Practice Address - Country:US
Practice Address - Phone:586-751-0999
Practice Address - Fax:586-751-1703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010613771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty