| Orchards Children's Services, Inc. | |
|
24901 Northwestern Hwy Ste 500 Southfield MI 48075-2212 | |
| (248) 258-0440 | |
| (248) 258-0458 |
| Full Name | Orchards Children's Services, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 24901 Northwestern Hwy Ste 500, Southfield, Michigan |
| Authorized Official Name and Position | Jeffery Joseph Lusko (CLINICAL PROGRAM MANAGER) |
| Authorized Official Contact | 2482580440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orchards Children's Services, Inc. 24901 Northwestern Hwy Ste 500 Southfield MI 48075-2212 Ph: (248) 258-0044 | Orchards Children's Services, Inc. 24901 Northwestern Hwy Ste 500 Southfield MI 48075-2212 Ph: (248) 258-0440 |
| NPI Number | 1356554059 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 04/15/2021 |
| Certification Date | 04/15/2021 |
| Medicare PECOS PAC ID | 4587037361 |
|---|---|
| Medicare Enrollment ID | O20230224002295 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356554059 | NPI | - | NPPES |
| 3471170 | Medicaid | MI |
| Provider Name | Shannon Laskey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609469303 PECOS PAC ID: 2668845447 Enrollment ID: I20230224002365 |
| Provider Name | Kelsey Wisotsky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700286994 PECOS PAC ID: 7911370796 Enrollment ID: I20230224002390 |
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