Basic Information
| Provider Information | |||||||||
| NPI: | 1093152092 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOLY CROSS YOUTH AND FAMILY SERVICES INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | KAIROS HEALTHCARE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8759 CLINTON MACON RD | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 492369572 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5174237556 | ||||||||
| FaxNumber: | 5174235442 | ||||||||
| Practice Location | |||||||||
| Address1: | 2084 HEMMETER RD | ||||||||
| Address2: | |||||||||
| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486033943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894017506 | ||||||||
| FaxNumber: | 9894017509 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2013 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | BAUDOUX | ||||||||
| AuthorizedOfficialFirstName: | PAULINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | REGIONAL OFFICE COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 9895963558 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | 730232 | MI | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.