| Family Service And Childrens Aid | |
|
330 W Michigan Ave Jackson MI 49201-2121 | |
| (517) 787-7920 | |
| (517) 787-2440 |
| Full Name | Family Service And Childrens Aid |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 330 W Michigan Ave, Jackson, Michigan |
| Authorized Official Name and Position | Teresa Ann Proctor (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 5177877920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Service And Childrens Aid 330 W Michigan Ave Jackson MI 49201-2121 Ph: (517) 787-7920 | Family Service And Childrens Aid 330 W Michigan Ave Jackson MI 49201-2121 Ph: (517) 787-7920 |
| NPI Number | 1699861609 |
|---|---|
| Provider Enumeration Date | 10/05/2006 |
| Last Update Date | 08/10/2023 |
| Certification Date | 08/10/2023 |
| Medicare PECOS PAC ID | 5698669612 |
|---|---|
| Medicare Enrollment ID | O20041112000406 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699861609 | NPI | - | NPPES |
| 138213 | Other | MI | CARE CHOICES |
| 398186150 | Other | MI | TRICARE DR S ONLY |
| 0056 | Other | MI | HEALTH PLAN OF MI |
| FAMIL-6361 | Other | MI | COMPCARE |
| 138213 | Other | MI | PREFFERED CHOICES |
| 260078000 | Other | MI | MAGELLAN EAP CAROL ONLY |
| FC-ADR-BF-122763 | Other | MI | GREAT LAKES |
| 1105443 | Other | MI | CONNECTICUT GENERAL |
| M#38002 | Other | MI | M-CARE |
| 750910682 | Other | MI | BLUE CROSS BLUE SHIELD |
| P50798 | Other | MI | GREAT LAKES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Michigan) | Primary |
| Provider Name | Emily A Vogel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326482035 PECOS PAC ID: 9234371097 Enrollment ID: I20130808000079 |
| Provider Name | Glen D Rickman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972037844 PECOS PAC ID: 2062857485 Enrollment ID: I20240226001391 |
| Provider Name | Shannon Douglas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225545650 PECOS PAC ID: 8426494600 Enrollment ID: I20240311000900 |
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