JACKSON-HILLSDALE COMMUNITY MENTAL HEALTH BOARD (NPI# 1063466274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063466274 |
| 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 | 5177891200 |
| Practice Fax Number | 5177891276 |
| Mailing Telephone | 5177891200 |
| Mailing Fax Number | 5177891276 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2012-07-05 |
| Authorized Official Name | MS. MARIBETH J CALDWELL (CHIEF EXECUTIVE OFFICER (CEO)) |
| Authorized Official Telephone | 5177891209 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 1712229 | 05 |
| Other Name | Type Code |
|---|---|
| LIFEWAYS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265795694 | Jackson-hillsdale Community Mental Health Board | Community/Behavioral Health | 1200 N West Ave, Jackson, MI 49202-2179 | 2012-06-20 |
| 1043530603 | Jackson-hillsdale Community Mental Health Board | Clinic/Center | 1200 N. West Avenue, Jackson, MI 49202 | 2010-06-07 |
| Street Address |
1200 N. WEST AVENUE |
| City | JACKSON |
| State | MI |
| Zip Code | 49202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043530603 | Jackson-hillsdale Community Mental Health Board | Clinic/Center | 1200 N. West Avenue, Jackson, MI 49202 | 2010-06-07 |
| 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 | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871103127 | Lupine Mental Health and Integrative Psychiatry LLC | Clinic/Center | 125 E Pearl Ave Ste 207, Jackson, WY 83001-8599 | 2020-08-02 |
| 1750908182 | Horizon Connections | Clinic/Center | 1818 Crane Ridge Dr Ste 101, Jackson, MS 39216-4912 | 2020-07-01 |
| 1295211787 | Nicole Rue, Psy.d., LLC | Clinic/Center | 1115 Maple Way Ste D, Jackson, WY 83001-8567 | 2018-07-17 |
| 1881102408 | Ava Family Services, LLC | Clinic/Center | 1910 Lakeland Dr Ste C, Jackson, MS 39216 | 2018-01-17 |
| 1033628466 | Bhg Lii, LLC | Clinic/Center | 794 Mcdonough Rd Ste 104, Jackson, GA 30233-1572 | 2017-09-28 |
| 1356732317 | Golden Gold Child Learning Center | Clinic/Center | 1155 Jackson Blvd, Jackson, MS 39204-2733 | 2015-02-12 |
| 1194964049 | Beacon Behavioral Health-jackson | Clinic/Center | 5360 I 55 N, Jackson, MS 39211-4026 | 2009-02-17 |
| 1134366867 | Mississippi State Hospital | Clinic/Center | 350 Capers Ave, Jackson, MS 39203-2131 | 2009-01-16 |
| 1780852194 | Mcwillie Counseling & Diagnostic Services | Clinic/Center | 5202 Keele St Ste 1, Jackson, MS 39206-4355 | 2008-02-19 |
| 1689628190 | Catholic Charities of Jackson, Lenawee and Hillsdale Counties | Clinic/Center | 1522 Joy Ave, Jackson, MI 49203-1933 | 2006-05-20 |
| 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.