Provider Demographics
NPI:1912227570
Name:LENAWEE COMMUNITY MENTAL HEALTH AUTHORITY
Entity Type:Organization
Organization Name:LENAWEE COMMUNITY MENTAL HEALTH AUTHORITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:SZEWCZUK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-263-8905
Mailing Address - Street 1:1040 S WINTER ST
Mailing Address - Street 2:SUITE #1022
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-3876
Mailing Address - Country:US
Mailing Address - Phone:517-263-8905
Mailing Address - Fax:517-263-7616
Practice Address - Street 1:1040 S WINTER ST
Practice Address - Street 2:SUITE #1022
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-3876
Practice Address - Country:US
Practice Address - Phone:517-263-8905
Practice Address - Fax:517-263-7616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4352870Medicaid
MI4352870Medicaid