EASTER SEALS - MICHIGAN, INC. (NPI# 1407013709) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407013709 |
| Entity Type | Organization |
| Organization Name | EASTER SEALS - MICHIGAN, INC. |
| Other Organization Name | FAMILY SERVICES SOUTH |
| Practice Address |
24445 Northwestern Hwy Ste 100 Southfield MI 48075-2436 |
| Mailing Address |
2387 E Walton Blvd Auburn Hills MI 48326-1955 |
| Practice Telephone | 2484837804 |
| Practice Fax Number | 2484837868 |
| Mailing Telephone | 2484756400 |
| Mailing Fax Number | 2484756402 |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2012-09-27 |
| Authorized Official Name | BRENT WIRTH (CEO/PRESIDENT) |
| Authorized Official Telephone | 2484756400 |
| Is Organization Subpart | Y |
| Parent Organization Name | EASTER SEALS - MICHIGAN, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Family Services South | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376526616 | Easter Seals - Michigan, Inc. | Psychiatry & Neurology | 2399 E Walton Blvd, Auburn Hills, MI 48326-1955 | 2005-11-21 |
| 1467619759 | Easter Seals - Michigan, Inc. | Community/Behavioral Health | 269 Summit Dr, Waterford, MI 48328-3364 | 2008-05-22 |
| 1750548046 | Easter Seals - Michigan, Inc. | Community/Behavioral Health | 22170 W 9 Mile Rd, Southfield, MI 48033-6007 | 2008-05-22 |
| 1023275328 | Easter Seals - Michigan, Inc. | Community/Behavioral Health | 1420 University Ave, Flint, MI 48504-6208 | 2008-05-22 |
| Street Address |
24445 NORTHWESTERN HWY STE 100 |
| City | SOUTHFIELD |
| State | MI |
| Zip Code | 48075-2436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457829590 | Madeline Grace Moore | Behavior Technician | 24445 Northwestern Hwy Ste 100, Southfield, MI 48075-2436 | 2018-11-07 |
| 1982010567 | Larissa Heise | Social Worker | 24445 Northwestern Hwy Ste 100, Southfield, MI 48075-2436 | 2014-07-03 |
| 1760813117 | Victoria Puchalski | Technician, Other | 24445 Northwestern Hwy Ste 100, Southfield, MI 48075-2436 | 2013-12-11 |
| 1659616035 | Nathan Vandeven Conn | Speech-Language Pathologist | 24445 Northwestern Hwy Ste 100, Southfield, MI 48075-2436 | 2012-12-11 |
| 1902151137 | Ayana N. Talley | Counselor | 24445 Northwestern Hwy Ste 100, Southfield, MI 48075-2436 | 2012-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851900054 | K&b Medical Wigs, LLC | Durable Medical Equipment & Medical Supplies | 16250 Northland Dr. Ste 221, Southfield, MI 48075 | 2020-07-24 |
| 1790300390 | Julian Jeberaeel | Radiology | 2250 Providence, Southfield, MI 48075 | 2020-06-10 |
| 1265056410 | Husein Yusuf Husein | Podiatrist | Ascension Providence Hospital Southfield Campus, 16001 W. Nine Mile Rd. Depaul 2nd Floor, Southfield, Mi, MI 48075 | 2020-06-03 |
| 1952945420 | Paris Straughter | Nurse Practitioner | 18438 Onyx St, Southfield, MI 48075 | 2019-10-29 |
| 1811467657 | Medicine Man Medical, Pllc | Physical Medicine & Rehabilitation | 25130 Southfield Road, Suite #210, Southfield, MI 48075 | 2018-12-04 |
| 1447725528 | Rommel Ramos Perez | Physical Therapist | 26017 Greenfield Rd., Southfield, MI 48075 | 2018-10-04 |
| 1073009627 | Jacqueline Venora Goodgame | Licensed Practical Nurse | 4000 Town Ctr, Southfield, MI 48075 | 2018-07-06 |
| 1043712532 | Hollie Marie Maltese | Physical Therapy Assistant | 22255 Greenfiled 118, Southfield, MI 48075 | 2018-03-01 |
| 1932601481 | Katie Marie Mccormack | Occupational Therapist | 16001 West Nine Mile Rd., Southfield, MI 48075 | 2018-03-01 |
| 1801304241 | Absolute Hc LLC | Physical Therapist | 23461 Greenfield Rd Ste 200b, Southfield, MI 48075 | 2018-01-19 |
| Find all providers in zip 48075 | ||||
| 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 |
|---|---|---|---|---|
| 1013524032 | I Need A Moment, LLC | Community/Behavioral Health | 20411 Alhambra St, Southfield, MI 48076-5422 | 2020-09-24 |
| 1780219196 | I. R. Horn & Associates LLC | Community/Behavioral Health | 29623 Norhtwestern Hwy Suite 5, Southfield, MI 48034 | 2020-03-05 |
| 1235774514 | Siebert Psychotherapy Services | Community/Behavioral Health | 29501 Greenfield Rd Ste 132, Southfield, MI 48076-2250 | 2019-11-11 |
| 1225682933 | Hydro Play LLC | Community/Behavioral Health | 21776 Colony Park Cir Apt 203, Southfield, MI 48076-1658 | 2019-07-31 |
| 1376017137 | Stacy K Doctoroff Lpc, LLC | Community/Behavioral Health | 29260 Franklin Rd Ste 111, Southfield, MI 48034-1196 | 2019-01-15 |
| 1295208361 | Sensible Counseling Pllc | Community/Behavioral Health | 15700 W 10 Mile Rd Ste 101a, Southfield, MI 48075-2100 | 2019-01-10 |
| 1477039055 | Faith Soars Counseling | Community/Behavioral Health | 24681 Northwestern Hwy Ste 303, Southfield, MI 48075-2322 | 2018-07-17 |
| 1033608054 | Healing Waters Grief Therapy Pllc | Community/Behavioral Health | 18444 W 10 Mile Rd Ste 204, Southfield, MI 48075-2626 | 2018-05-04 |
| 1023552361 | Massage Serenity | Community/Behavioral Health | 20245 W. 12 Mile Rd, Suite 113, Southfield, MI 48076 | 2016-12-06 |
| 1760925267 | 1 Percent LLC | Community/Behavioral Health | 27090 Devonshire St, Southfield, MI 48076-3139 | 2016-12-01 |
| Find all providers in SOUTHFIELD | ||||
| City | SOUTHFIELD |
| Zip Code | 48075 |
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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.