Boysville of Michigan, Inc.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

SA0330349 Issued in MI

Legal business name

BOYSVILLE OF MICHIGAN, INC.

Doing business as

Holy Cross Services

Practice address

3410 Old Lansing Rd
Lansing, MI 48917-4392

Phone

(517) 657-2980

Fax

(517) 993-5982

NPI assigned

Aug 3, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Pauline M Baudoux

Title

Regional Office Coordinator

Phone

(989) 596-3558

Specialties & licenses 1

Addresses

Other names 1

• Holy Cross Services Doing business as

Tax ID family

Boysville of Michigan Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Boysville of Michigan, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Pontiac, MI
  • NPI 1184061426
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1578949400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 N RIVER RD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486096833",
            "telephone_number": "989-596-3558",
            "fax_number": "989-401-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 OLD LANSING RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174392",
            "telephone_number": "517-657-2980",
            "fax_number": "517-993-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYSVILLE OF MICHIGAN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-03",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "BAUDOUX",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "REGIONAL OFFICE COORDINATOR",
        "authorized_official_telephone_number": "989-596-3558"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "MI",
            "license": "SA0330349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Holy Cross Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Holy Cross Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Jenine Boyd, MA, CCC-SLP-L
• Monique Boykins
• Madison Boyle
• Maura Elizabeth Boyle, RPH
• Cynthia S. Boynton, M.D.
• Judith Ann Bozzo, MPA/HEALTH CARE
• Tammie Bozzo
• Sarah Brabant
• Alexander Brace
• Domonique Brace

• Substance Abuse Rehabilitation Facility in Lansing, MI
• Providers in Lansing, MI by specialty
• Substance Abuse Rehabilitation Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.