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Organization

THE LANG FOUNDATION

Active
Other names
The Lang Foundation
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLIE COCHRAN (PRESIDENT)
(313) 329-0724
Entity
Organization

Contact information

Practice address
1897 STANLEY BLVD, BIRMINGHAM, MI 48009
(313) 442-6027
Mailing address
1897 STANLEY BLVD, BIRMINGHAM, MI 48009-4149
(313) 442-6027

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
251B00000X
Case Management Agency
251K00000X
Public Health or Welfare Agency
251S00000X
Community/Behavioral Health Agency
252Y00000X
Early Intervention Provider Agency
261Q00000X
Clinic/Center
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0855X
Adolescent and Children Mental Health Clinic/Center
261QM3000X
Medically Fragile Infants and Children Day Care
320800000X
Mental Illness Community Based Residential Treatment Facility
3245S0500X
Children's Substance Abuse Rehabilitation Facility

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1215428586
MI
Enumeration date
05/22/2018
Last updated
07/17/2018
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