Organization
KAIROS HEALTHCARE INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRED E. WIGEN JR. (PRESIDENT/CEO)
(989) 777-4357
Entity
Organization
Contact information
Practice address
6379 DIXIE HWY, BRIDGEPORT, MI 48722-9566
(989) 777-4357
(989) 777-7257
Mailing address
6379 DIXIE HWY, BRIDGEPORT, MI 48722-9566
(989) 777-4357
(989) 777-7257
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
730157
MI
104100000X
Social Worker
730157
MI
324500000X
Substance Abuse Rehabilitation Facility
730157
MI
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
730157
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0K47927
HEALTH PLUS PIN
MI
01
—
1008848
MCCLAREN PIN
MI
01
—
14072
MCARE PIN
MI
01
—
20520
BCBS OF MI
MI
01
—
328565
VALUE OPTIONS PIN
MI
Enumeration date
08/18/2006
Last updated
01/02/2008
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