Provider Demographics
NPI:1932574522
Name:WOMEN AND GIRLS EMPOWERMENT CENTER LLC
Entity Type:Organization
Organization Name:WOMEN AND GIRLS EMPOWERMENT CENTER LLC
Other - Org Name:WAGE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERSECHINI
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, CAADC, CTS
Authorized Official - Phone:734-656-8225
Mailing Address - Street 1:164 N. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170
Mailing Address - Country:US
Mailing Address - Phone:734-656-8225
Mailing Address - Fax:
Practice Address - Street 1:164 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1236
Practice Address - Country:US
Practice Address - Phone:734-656-8225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health