JACKSON-HILLSDALE COMMUNITY MENTAL HEALTH BOARD (NPI# 1043530603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043530603 |
| Entity Type | Organization |
| Organization Name | JACKSON-HILLSDALE COMMUNITY MENTAL HEALTH BOARD |
| Other Organization Name | LIFEWAYS |
| Practice Address |
1200 N. West Avenue Jackson MI 49202 |
| Practice Telephone | 5177803332 |
| Practice Fax Number | 5177964532 |
| Mailing Telephone | 5177803332 |
| Mailing Fax Number | 5177964532 |
| Enumeration Date | 2010-06-07 |
| Last Update Date | 2012-07-12 |
| Authorized Official Name | MS. MARIBETH CALDWELL (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5177891208 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 171229 | 05 | |
| MI | 1712229 | 05 | |
| MI | MEDICARE ID | 0C87612 | 01 |
| Other Name | Type Code |
|---|---|
| LIFEWAYS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063466274 | Jackson-hillsdale Community Mental Health Board | Clinic/Center | 1200 N. West Avenue, Jackson, MI 49202 | 2006-05-20 |
| 1265795694 | Jackson-hillsdale Community Mental Health Board | Community/Behavioral Health | 1200 N West Ave, Jackson, MI 49202-2179 | 2012-06-20 |
| Street Address |
1200 N. WEST AVENUE |
| City | JACKSON |
| State | MI |
| Zip Code | 49202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063466274 | Jackson-hillsdale Community Mental Health Board | Clinic/Center | 1200 N. West Avenue, Jackson, MI 49202 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437768801 | Abc Center for Learning Inc | Community/Behavioral Health | 4939 Ledgerock St, Jackson, MI 49201-8128 | 2020-07-30 |
| 1538703053 | Quest Fitness | Community/Behavioral Health | 1693 Lakeover Rd, Jackson, MS 39213-8015 | 2019-10-29 |
| 1326502535 | V.k. Johnson, Lcsw & Consultants, LLC | Community/Behavioral Health | 2637 Ridgewood Rd Ste De, Jackson, MS 39216-4922 | 2019-01-22 |
| 1215410816 | Feed Your Soul LLC | Community/Behavioral Health | 180 W University Pkwy Ste D, Jackson, TN 38305-1612 | 2018-09-10 |
| 1184103061 | Ymca of Greater Monmouth County | Community/Behavioral Health | 1025 Larsen Rd, Jackson, NJ 08527-1315 | 2018-08-10 |
| 1649759523 | Ymca of Greater Monmouth County | Community/Behavioral Health | 75 W Veterans Hwy, Jackson, NJ 08527-3403 | 2018-08-10 |
| 1558840439 | Ymca of Greater Monmouth County | Community/Behavioral Health | 125 N Hope Chapel Rd, Jackson, NJ 08527-2962 | 2018-08-10 |
| 1417436544 | Ymca of Greater Monmouth County | Community/Behavioral Health | 35 S Hope Chapel Rd, Jackson, NJ 08527-5019 | 2018-08-09 |
| 1568964112 | Apluscare, LLC | Community/Behavioral Health | 613 Atterbury Ct E, Jackson, NJ 08527-3182 | 2018-02-28 |
| 1043722465 | Apluscare, LLC | Community/Behavioral Health | 1012 Atterbury Ct E, Jackson, NJ 08527-3186 | 2017-10-25 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.