Provider Demographics
NPI: | 1043648520 |
---|---|
Name: | HUMAN DEVELOPMENT COMMISSION |
Entity type: | Organization |
Organization Name: | HUMAN DEVELOPMENT COMMISSION |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LORI |
Authorized Official - Middle Name: | KAY |
Authorized Official - Last Name: | OFFENBECHER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 989-673-4121 |
Mailing Address - Street 1: | 429 MONTAGUE AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | CARO |
Mailing Address - State: | MI |
Mailing Address - Zip Code: | 48723-1921 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 989-673-4121 |
Mailing Address - Fax: | 989-673-2031 |
Practice Address - Street 1: | 429 MONTAGUE AVE |
Practice Address - Street 2: | |
Practice Address - City: | CARO |
Practice Address - State: | MI |
Practice Address - Zip Code: | 48723-1921 |
Practice Address - Country: | US |
Practice Address - Phone: | 989-673-4121 |
Practice Address - Fax: | 989-673-2031 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-10-22 |
Last Update Date: | 2013-10-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 347C00000X | Transportation Services | Private Vehicle | |
No | 251V00000X | Agencies | Voluntary or Charitable | |
No | 253Z00000X | Agencies | In Home Supportive Care |