Organization
THE CHILDREN'S CENTER OF WAYNE CO., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY LEID (DIRECTOR - RCM & CLIENT RELATIONS)
(313) 262-0951
Entity
Organization
Contact information
Practice address
79 W ALEXANDRINE ST, DETROIT, MI 48201-2015
(313) 831-5535
(313) 447-2623
Mailing address
79 W ALEXANDRINE ST, DETROIT, MI 48201-2015
(313) 831-5535
(313) 447-2623
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253J00000X
Foster Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000100
CARELINK
MI
01
—
118605
VALUE OPTIONS
MI
01
—
1528145844
BCN
MI
05
—
21 3119549
—
MI
01
—
653610
CONSUMERLINK
MI
01
—
750910564
BCBS
MI
Enumeration date
11/01/2006
Last updated
05/23/2022
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