FAIRSKY FOUNDATION NPI 1033595665

NPI Information

NPI: 1033595665
Provider Name: FAIRSKY FOUNDATION
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
23231 WOODWARD AVE
FERNDALE, MI
ZIP 48220
Phone: (248) 581-8777
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FAIRSKY FOUNDATION is a multi-specialty clinic center in Ferndale, MI. FAIRSKY FOUNDATION NPI is 1033595665. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

23231 WOODWARD AVE
FERNDALE, MI
ZIP 48220-361
Phone: (248) 581-8777
Fax: (888) 975-9374

The provider's authorized official is David St. John .
The authorized official title is Executive Director and has the following contact phone number (248) 581-8777.

The enumeration date for this NPI number is 8/5/2015 and was last updated on 8/23/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YP2500X	Counselor	Professional	No
2	103TC0700X	Psychologist	Clinical	No
3	1041C0700X	Social Worker	Clinical	No
4	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
5	261QM1300X	Clinic/Center	Multi-Specialty	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CV0058149	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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