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Organization

COMMUNITY ACTION AGENCY

Active
Parent organization
WOMEN INFANTS CHILDREN
Other names
W.I.C
Organization subpart
Yes

Provider details

NPI number
Legal business name
WOMEN INFANTS CHILDREN
Authorized official
TOBY BERRY (CHIEF EXECUTIVE OFFICER)
(517) 539-8311
Entity
Organization

Contact information

Practice address
400 W SOUTH ST, ADRIAN, MI 49221-3825
(517) 263-7861
(517) 263-6531
Mailing address
400 W SOUTH ST, ADRIAN, MI 49221-3825
(517) 263-7861
(517) 263-6531

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
4703062118
MI
305S00000X
Point of Service
4703062118
MI

Other

Enumeration date
12/23/2008
Last updated
09/20/2024
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