Provider Demographics
NPI:1770994980
Name:STARFISH FAMILY SERVICES
Entity type:Organization
Organization Name:STARFISH FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-728-3400
Mailing Address - Street 1:30000 HIVELEY ST
Mailing Address - Street 2:
Mailing Address - City:INKSTER
Mailing Address - State:MI
Mailing Address - Zip Code:48141-1089
Mailing Address - Country:US
Mailing Address - Phone:734-728-3400
Mailing Address - Fax:734-728-3500
Practice Address - Street 1:30000 HIVELEY ST
Practice Address - Street 2:
Practice Address - City:INKSTER
Practice Address - State:MI
Practice Address - Zip Code:48141-1089
Practice Address - Country:US
Practice Address - Phone:734-728-3400
Practice Address - Fax:734-728-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI2332Medicare PIN