Community Care Services

NPI 1023146792 - Exclusive Provider Organization - 302F00000X

NPI Details
NPI 1023146792
Enumeration Date 03/02/2007
Last Updated 08/30/2011
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name RAYMOND KYLE RAYMOND
Position MENTAL HEALTH THERAPIST III
Phone (313) 382-7861
Fax
Practice Location
1736 FORT ST
LINCOLN PARK MI, 48146-1904, US
Phone (313) 382-7861
Fax
Business Location
28541 SPRUCE DR
FLAT ROCK MI, 48134-9772, US
Phone (734) 782-4453
Fax
Toxanomy
Taxonomy Code 302F00000X
License State
License Number
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According to our database, Community Care Services NPI is 1023146792, taxonomy code is 302F00000X Community Care Services physically located at 1736 Fort St, Lincoln Park MI, 48146-1904. NPI Number 1033115704 has the healthcare provider type.

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1023146792 NPI number is provided on an as is basis without warranty of any kind. 1023146792 is maintained by the National Plan & Provider Enumeration System. The contents of Community Care Services are for informational purposes only.