OrganizationActive
Innovative Child & Family Services
NPI 1497358865 · Adolescent and Children Mental Health Clinic/Center · Lansing, MI
Provider details
- NPI number
- 1497358865
- Entity type
- Organization
- Primary specialty
- Adolescent and Children Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ricardo Tillery, Ceo(517) 703-3387
Specialties & taxonomies
Ambulatory Health Care Facilities
- Meals Provider174200000X
Other Service Providers
- Lodging Provider177F00000X
Other Service Providers
- Local Education Agency (LEA)251300000X
Agencies
- Case Management Agency251B00000X
Agencies
- Public Health or Welfare Agency251K00000X
Agencies
- In Home Supportive Care Agency253Z00000X
Agencies
Practice location
3721 W Michigan Ave
Lansing, MI 48917-3693
Phone: (517) 515-6176
Approximate (ZIP-level) locationGet directions
Mailing address
3721 W Michigan Ave
Lansing, MI 48917-3693
Registry dates
- Enumerated
- 2020-11-18
- Last updated
- 2020-11-18
- Certified
- 2020-11-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.