Organization
THE FIRECRACKER FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TASHMICA TOROK (EXECUTIVE DIRECTOR)
(517) 242-5467
Entity
Organization
Contact information
Practice address
2450 DELHI COMMERCE DR STE 9, HOLT, MI 48842-2193
(517) 242-5467
Mailing address
2450 DELHI COMMERCE DR STE 9, HOLT, MI 48842-2193
(517) 242-5467
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/21/2017
Last updated
07/21/2022
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