Basic Information
| Provider Information | |||||||||
| NPI: | 1073990685 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY WORK OPPORTUNITIES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5900 N LILLEY RD | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481873776 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349813709 | ||||||||
| FaxNumber: | 7349815384 | ||||||||
| Practice Location | |||||||||
| Address1: | 5900 N LILLEY RD | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481873776 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349813709 | ||||||||
| FaxNumber: | 7349815384 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2015 | ||||||||
| LastUpdateDate: | 05/04/2015 | ||||||||
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| AuthorizedOfficialLastName: | LAMONTAGNE | ||||||||
| AuthorizedOfficialFirstName: | ELAINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7349813709 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | QUEST INC. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251C00000X | MI | Y | Agencies | Day Training, Developmentally Disabled Services |
No ID Information.