NPIMap

Organization Active NPI

Family Service and Childrens Aid

  • Community/Behavioral Health Agency
  • Jackson, MI
National Provider Identifier
1699861609
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
FAMILY SERVICE AND CHILDRENS AID
Practice address
330 W Michigan Ave
Jackson, MI 49201-2121
Phone
(517) 787-7920
Fax
(517) 787-2440
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Authorized official

Name
Teresa Ann Proctor
Title
Chief Administrative Officer
Phone
(517) 787-7920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X MI Primary

Addresses

Primary practice location

330 W Michigan Ave
Jackson, MI 49201-2121

Mailing address

330 W Michigan Ave
Jackson, MI 49201-2121
Phone (517) 787-7920

Other identifiers 11

IdentifierTypeStateIssuer
138213OtherMICARE CHOICES
398186150OtherMITRICARE DR S ONLY
0056OtherMIHEALTH PLAN OF MI
FAMIL-6361OtherMICOMPCARE
138213OtherMIPREFFERED CHOICES
260078000OtherMIMAGELLAN EAP CAROL ONLY
FC-ADR-BF-122763OtherMIGREAT LAKES
1105443OtherMICONNECTICUT GENERAL
M#38002OtherMIM-CARE
750910682OtherMIBLUE CROSS BLUE SHIELD
P50798OtherMIGREAT LAKES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041112000406 MI Part B Supplier - Clinic/Group Practice 5698669612 Receives reassigned benefits from 3 practitioners
Practice locations: Jackson, MI

National Provider Directory

National Provider Directory

Locations

3266 N Adrian Hwy
Adrian, MI 49221
Phone (517) 263-2625

306 W Michigan Ave
Jackson, MI 49201
Phone (517) 257-3981

300 W Louis Glick Hwy
Jackson, MI 49201
Phone (517) 782-9905

330 W Michigan Ave
Jackson, MI 49201
Phone (517) 706-7994

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1699861609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012121",
            "telephone_number": "517-787-7920",
            "fax_number": "517-787-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012121",
            "telephone_number": "517-787-7920",
            "fax_number": "517-787-2440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SERVICE AND CHILDRENS AID",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "517-787-7920"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE CHOICES",
            "identifier": "138213",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE DR S ONLY",
            "identifier": "398186150",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLAN OF MI",
            "identifier": "0056",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPCARE",
            "identifier": "FAMIL-6361",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFFERED CHOICES",
            "identifier": "138213",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN EAP CAROL ONLY",
            "identifier": "260078000",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES",
            "identifier": "FC-ADR-BF-122763",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICUT GENERAL",
            "identifier": "1105443",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "M#38002",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "750910682",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES",
            "identifier": "P50798",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.