Basic Information
| Provider Information | |||||||||
| NPI: | 1003020553 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CATHOLIC SOCIAL SERVICES OF OAKLAND COUNTY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1424 E 11 MILE RD | ||||||||
| Address2: | |||||||||
| City: | ROYAL OAK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480672026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485484044 | ||||||||
| FaxNumber: | 2485489239 | ||||||||
| Practice Location | |||||||||
| Address1: | 1424 E 11 MILE RD | ||||||||
| Address2: | |||||||||
| City: | ROYAL OAK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480672026 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485484044 | ||||||||
| FaxNumber: | 2485489239 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2007 | ||||||||
| LastUpdateDate: | 08/20/2008 | ||||||||
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| AuthorizedOfficialLastName: | HAGAR | ||||||||
| AuthorizedOfficialFirstName: | TAMARA | ||||||||
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| AuthorizedOfficialTitleorPosition: | SITE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2485484044 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.