Organization
FAMILY SERVICE AND CHILDRENS AID
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA ANN PROCTOR (CHIEF ADMINISTRATIVE OFFICER)
(517) 787-7920
Entity
Organization
Contact information
Practice address
330 W MICHIGAN AVE, JACKSON, MI 49201-2121
(517) 787-7920
(517) 787-2440
Mailing address
330 W MICHIGAN AVE, JACKSON, MI 49201-2121
(517) 787-7920
(517) 787-2440
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0056
HEALTH PLAN OF MI
MI
01
—
1105443
CONNECTICUT GENERAL
MI
01
—
138213
CARE CHOICES
MI
01
—
260078000
MAGELLAN EAP CAROL ONLY
MI
01
—
398186150
TRICARE DR S ONLY
MI
01
—
750910682
BLUE CROSS BLUE SHIELD
MI
01
—
FAMIL-6361
COMPCARE
MI
01
—
FC-ADR-BF-122763
GREAT LAKES
MI
01
—
M#38002
M-CARE
MI
01
—
P50798
GREAT LAKES
MI
Enumeration date
10/05/2006
Last updated
08/10/2023
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